Is A Capitalist Meltdown Upon Us?        
I'll only be 53 on my next birthday in late July, yet it already seems like I've lived a tiring amount of history. Only 20 years ago, the world saw the meltdown of Soviet-style communism -- and many observers, largely neo-conservatives, interpreted that as an ideological culmination, "the end of history." There was even an influential book written with that title. (Does anyone remember that author now? And, does he want to remember that book? Yeah, I know -- Francis Fukuyama.)

It appears that reversals of fortune can happen quickly. Now it looks like the allegedly venerable ideology of "free-market" capitalism is on the ropes, and in serious danger of going down. Who would have thought it?

Die-hard Marxists did. I've never been one of them, even as a long-ago radical all of 23 years old. I still know three people who have continued to call themselves Marxists in total defiance of dismissal or ridicule, and they are probably gloating a lot now. The economic train wreck they kept dogmatically predicting finally seems to be in front of us.

But even as America sleepwalked through our Second Gilded Age (circa 1981-2005), I grew skeptical of the Marxist vision. "Historical inevitability" always sounded like a religious tenet, without the pure superstition; and Marxism itself, a sort of quasi-religion for embittered atheists.

We should be as cautious about awarding hard-line socialists a victory here, as much as "we" (in the editorial sense) should have checked for our wallets the minute Reagan started talking about trickle-down and Phil Gramm started talking about deregulation. The past century should have taught us that the answer lies in between.

Starting with the excesses of laissez-faire: America has, for the past 30-ish years, seen the roller-coaster ride that happens with that sort of economic policy. An elite grows very rich, a minority near the bottom slips much further down, and most people tend to stagnate in the middle.

There are cycles of boom and bust. The booms are good for most people, but especially good for a few. The latter group inevitably forms a "Why Should I Have To Pay Taxes?" lobby and gets bonanzas from lawmakers eager to please. And since these are the people of ostentation and material success, their influence is great among fashionable "thinkers" of the day.

Now the big bust is upon us. It's a bit like 1933 all over again -- not as grim or total in devastation, but it's likely to get worse. President Barack Obama has warned us that this is so.

But history, with its entire lesson, should be heeded, and it seems like Obama is one who will do so.

There were very good reasons for the meltdown of the Soviet empire 20 years ago. Contrary to right-wing mythology, Reagan and his military buildup had little to do with it. Post-Soviet Russian economists recall the problems as internal, and any intellectually honest person knew what they were. There's no need for me to recite the litany here -- Americans heard it all for decades.

But, let's face it, die-hard socialists out there -- state-run enterprises have a poor track record. The employees seem to lack incentives to produce. Cooperatives tend to degenerate into personal conflict, power struggles and chaos. And as for the concentration of power in the hands of "vanguard revolutionaries" -- the horrors and enormities of that have been abundant just in the past century.

I don't think it's hard to argue for a sense of balance and measure. In America, it seems like the compromising wheeler-dealers -- the FDRs, the Trumans, the LBJs, the Ted Kennedys -- got more done for working Americans than any of our homegrown radicals ever did.

But there is little doubt that there's been a sea change, and it's been back toward socialist thinking. The Nobel Prize committees have not been known for their sympathy toward socialist-leaning economists, yet Nobel Laureate economist Joseph Stiglitz has more or less come out in favor of the nationalization of U.S. banks. That would be a major step toward socialism of some fashion. Why not? We've just given the bastards $700 billion in taxpayer money to keep them in business. Here's a link to the interview with Stiglitz.

And, it appears that such state power would be the only thing to force the shameless swine who run these enterprises to behave themselves. Sen. Claire McCaskill, D-Mo., made a speech on the Senate floor about the Wall Street oinkers who had themselves awarded $18.4 billion in bonuses while their enterprises got in on the aforementioned $700 billion, because of reckless and disastrous mismanagement. Here's another link to reports on this issue, and to a video of McCaskill's speech. Be patient, the video seems very rough.

So, what should be the ultimate American destination, in an era of "capitalist" meltdown? The Swedes, with a hybrid socialist-capitalist system, don't seem to do badly, with avowed Socialists predominantly in power since 1929. Their booms are smaller, but so are their busts. Their people don't live in fear of homelessness or inability to afford basic health care. Right-wing humorist P.J. O'Rourke, when asked about the Swedes' seeming happiness with their stable system, said that they are all insane -- but that their insanity is distributed equally among the people.

It's a funny line. But there's nothing funny about facing a mortgage foreclosure, or about the welfare rolls shrinking even as joblessness is rapidly expanding. With a growing U.S. underclass, it may be time to take a second look at the socialist mind-set -- despite the old Marxist baggage. Nobody requires us to go to extremes.

Crossposted at Manifesto Joe.
          WA wants Social Security to provide affordable health insurance to 15K workers        

Not having a Social Security number is about to cause 15 thousand individuals in Washington State to lose their Basic Health affordable health insurance coverage.

Insurance and Money: 

          CARF Connection - The CARF portable profile - A standard, tool, and process - 2011 - PDF        

A portable profile includes basic health information, such as advance directives, allergies, functional status, emergency contacts, medical conditions, and medications. The absence of a health information organizing system makes it difficult for persons served to participate effectively in their own care. It also makes it difficult for service providers to respond appropriately to a person’s total health picture.

          Microbiology at Bayalpata Hosptial         
The staff at Bayalpata are always busy trying to find ways to improve and become more efficient. The focus on improvement doesn't leave much room for reminiscence. For a newcomer like myself I was preoccupied with how far the hospital has come since its opened its doors four years ago. The progress is even more impressive considering the formidable obstacles that Nyaya Health has faced and continues to face. 

Not only has Nyaya Health succeeded in establishing a free hospital in Far Western Nepal that provides basic health services, but it also continuously tries to expand its services. Take for example Bayalpata Hospital's Microbiology Lab that is currently expanding to include a bacterial culture facility. 

Bayalpata's lab is the only one of its kind in the district of Achham. It is currently staffed by four lab technicians and is equipped with an I-stat machine, a QBC Hematology Analyzer and a number of important serology tests, including HIV, Malaria, TB, and Hep-B. Having an in-house laboratory with the ability to analyze patients blood, kidney, and liver functions has allowed the physicians to more quickly and accurately diagnose their patients. The lab technicians approximate that they run biochemistry tests on 50 patients a day, at times discovering patients that are HIV+ and unaware of their condition. These patients can then be referred to Bayalpata's Anti-retroviral Therapy program. The biochemistry tests at the lab also allow the technicians to spot unusually high white blood cell counts that may be diagnosed by the doctors as leukemia. 

In the next few days, the technicians hope to begin growing and preserving bacteria cultures which will allow them to increase their diagnostic capabilities as well as pursue academic research, particularly concerning antibiotic resistant bacteria. Bayalpata is currently treating two patients that are suffering from multi-drug resistant tuberculosis. The capability of testing cultures with antibiotics can allow drug resistant strains to be more quickly recognized.

When Nyaya Health was founded in 2006, it opened a clinic in an abandoned goat shed. Today it is operating one of the few microbiology laboratories outside of Kathmandu. Hopefully similar progress is made over the next four years.

Bishnu, one of the four lab technicians working in the renovated microbiology lab at Bayalpata Hospital


People who gush with hope and optimism about the future are few and far between. One of them is Peter Diamandis, a fifty-one year old aerospace engineer and medical doctor, who gives us an upbeat assessment in his book, Abundance: The Future Is Better Than You Think. (1) The key to a prosperous planetary future, according to Diamandis, is to "raise global standards of living," with special focus on the worst off, mainly Africans, whom he calls the "bottom billion." Abundance, he holds, starts with satisfying the basic needs of everyone on the planet, a goal toward which, he claims, significant progress has already begun. While Diamandis expects the developed nations and the U.N. to support the quest for abundance, he argues that three other ingredients are essential.

The first is Do-It-Yourself "maverick innovators" who relish a challenge and who work in small groups, usually independent of government and universities, to develop technological marvels. Since technology matures exponentially, he argues, it has a "staggering potential" to improve global standards of living. Diamandis gives dozens of examples of Do-It-Yourselfers who have changed the world. For instance, Dean Kamen built a device that purifies water with miniscule amounts of energy; Burt Rutan inaugurated private space travel; Chris Anderson invented the drone; and a small group of friends in California, who dubbed themselves the Homebrew Computer Club, spawned twenty-three companies, including Apple. (2)

The second is a new breed of wealthy and generous benefactors who are committed to improving the world. Most of them earned fortunes early in life, mainly in computers and mobile phones. He calls them techno-philanthropists. For instance, Bill Gates of Microsoft is spreading a vaccine around the world to combat malaria, and Jeff Skoal of e-Bay has awarded $250 million to eighty-one entrepreneurs working to improve life on five continents. (3)

The third is significant cash prizes, sponsored by techno-philanthropists, foundations, governments, and corporations, to induce competition among teams of Do-It-Yourselfers to tackle formidable global challenges. Diamandis cites many historical examples of the success of such prizes. For instance, the lure for Charles Lindbergh'sNew YorktoParisflight in 1927 was a $25,000 prize. Diamandis is convinced that such incentives can produce technological breakthroughs to bring the entire world safe water, abundant food, electricity, toilets and sewers, basic health care, housing, education, modern banking and transportation, and hundreds of low-cost products.

Diamandis's message is refreshing, even inspiring, but he may be written off as a

modern-day Dr. Pangloss, the pie-in-the-sky optimist in Voltaire's Candide, unless he overcomes a major hurdle - funding. Although his X PRIZE Foundation has attracted sponsors of cash prizes for six projects so far, it hopes to secure funding for more than eighty others. One wonders how much nations stricken with debts and deficits can help. Hopefully, many more of the world's wealthy, including the one-thousand billionaires, will step up to the plate.


  1. Free Press, 2012, 386 pages. Steven Kotler, a science journalist, assisted Diamandis with the book, and is listed as a co-author. Diamandis established theInternationalSpaceUniversityto promote space exploration, the X PRIZE Foundation to provide incentives for discoveries that can benefit millions of people, andSingularityUniversityto offer courses, degrees, and conferences about problems facing the world and their potential solutions. He took undergraduate and graduate engineering degrees from MIT and a M.D. from Harvard.
  2. Also, Tony Spear came up with the proposal to use air bags to cushion the landing of an unmanned rover on Mars, which worked, and Craig Venter fully sequenced the human genome in less that one year for less than $100 million. By contrast, the U.S. Government spent ten years and $1.5 billion to do this. Venter is now developing synthetic life that can manufacture ultra-low-cost fuels.
  3. Techno-philanthropists also subsidize dozens of organizations such as Camfed, led by Ann Cotton, which has educated over a quarter million girls in Africa, and the Acumen Fund, led by Jacqueline Novogratz, which has invested $75 million in seventy companies in South Asia andAfricato deliver affordable health care, water, housing, and energy to the poor.

© 2012 Tom Shipka

          Helping Patients in Afghanistan Manage Their Diabetes #HelptheHelpers        

Direct Relief
Direct Relief -

Nearly 40 percent of the Afghan population lacks access to basic health services, causing many to suffer from serious, yet preventable, diseases. […]

Helping Patients in Afghanistan Manage Their Diabetes #HelptheHelpers
Bryn Blanks

          Acupuncture & Placenta Encapsulation        
After giving birth to Camilyn, Misty decided to have her placenta encapsulated to help with the production of milk while breast feeding, to raise her iron levels, and to help with any postpartum depression by supporting her hormones.  Placenta encapsulation is when they take the placenta, soak it in oil, dry it out, grind it up into powder, and then place it into capsules.

Placenta capsules.
Many mothers who have had it done and taken the pills, claim that it really helps.  Misty said it made a big difference in her recovery compared to her past six deliveries without having her placenta encapsulated.

Kaci was one recommendation who we ended up using to encapsulate Misty's placenta for $165.00 who lived in Rapid City, SD near where we were staying.  Most who practice this art will also practice other forms of the Chinese medicine which Kaci does, so she is also certified in acupuncture, reflexology, cupping, and Asian bodywork.

If interested in any of her services, you can click on her name above, email her at, or call her at 605-646-0305.

I'm not sure if the below picture is representative of American Gothic or Green Acres, but they are a very good looking family and really nice people that we are happy to have met.
Kaci with her husband Mark and son Kane.
I have always wanted to try acupuncture so Misty set up an appointment with Kaci for me to see what it was like.  After asking me some basic health questions, taking my blood pressure, and answering any questions I had, she proceeded to start the treatment. She ended up performing a kidney qi deficiency and liver qi stagnation on me where she used points to try to re-balance those organs but also used general calming points as well.  I have to say I did feel an energy throughout my body while receiving treatment.

Before starting the treatment my blood pressure was 120 over 90 and after the 30 minute session it dropped to 120 over 80, so if anything it relaxed me pretty good.  I really should have it performed on me a few more times to reap a better benefit, but it did help me to relax and feel refreshed when it was complete.
Getting acupuncture in my legs.
A full body view of my acupuncture procedure.
A shot of my acupuncture to my head, arms, and stomach.
Acupuncture needles in my ear.
I will try this again in the future and see if I get the same results.  It can take five to ten sessions before you see lasting results, but you will usually see some type of pain relief or feel something positive your first time, but everyone is different, so results will vary.

I personally know an individual who has acupuncture on his back for chronic pain relief and swears by it, but he has to keep going back for more treatments to keep the pain in check.  He says it is well worth it though.

Well hopefully my experience will make you want to experience acupuncture and see if it will help you too.  May Misty's experience also entice some expecting mothers to have their placenta encapsulated to help with the post birth issues.  Just because you have never done it or think it is weird, does not mean it will not work or help you in some way.

God bless and may you find what's best for your pain relief.  Of course a good prayer to your maker and trusting Him to take care of anything that comes your way, is always the best way to handle it.

If you are not following our blog, please do so and also become a friend on Facebook.  We would love to have you.

Don, Misty, and Kids...
Twenty Five States Visited So Far.

          10 Poorest Countries In The World | Ten Poorest Countries In list        

10. Ethiopia (GDP – per capita: $700)

Seen Better Days - Ethiopia
“The Sadomo region of the Ethiopia is known for producing the best coffee second to Harar….Make Trade Fair!” – mcandrea
Ethiopia ranks 170 out of 177 the poorest countries on the Human Development Index (UNDP HDI 2006). Half of its GDP depends on agricultural activity. The agricultural sector suffers lowdown because of poor cultivation techniques and frequent drought. 50% of its population 74.7 million bears the burden of poverty and 80% lives on bread line. 47% of males and 31% of females are literate. Some parts of Ethiopia run a high risk of hepatitis A, hepatitis E, typhoid fever, malaria, rabies, meningococcal meningitis and schistosomiasis.
Child Poverty

09. Niger (GDP – per capita: $700)

Niger with a population of 12.5 million is one of the ten poorest countries in the world. Drought is a common natural calamity in Niger. It often undergoes a phase of severe food crisis. 63% of its total population lives on below $1 a day. Adult literacy rate is as low as 15%. Life expectancy spans up to 46 years. A number of people die of hepatitis A, diarrhea, malaria, meningococcal meningitis and typhoid fever.
“Escaping from poverty”

08. Central African Republic (GDP – per capita: $700)

Rebel in northern Central African Republic
“Rebel in northern Central African Republic”
The Central African Republic ranks 171 as a poor country. Agriculture is the backbone of its unstable economy. Life expectancy of its meager population 4.3 ranges from 43.46 to 43.62 years. 13.5% of its population is at risk of AIDS.
Destruction in the north-west
“Boy in front of destroyed homes in Ngaoundaye, Central African Republic. Since early 2007, the troubled region has been caught up in fighting between APRD rebels and government troops.” – hdptcar

07. Guinea-Bissau (GDP – per capita: $600)

“Africa, Guinea-Bissau, Bijene, January 2005. Mbemba Djaló, 13 years young, earns some extra cash after school, running his little shop at the veranda of an abandoned colonial house. Photography by Ernst Schade” – ernst schade
The rank of Guinea Bissau as a poor country is 172. Farming and fishing are the only pillars of its economy. The level of income is not even in all parts of the country. About 10% of its adult population is at risk of HIV.

06. Union of the Comoros (GDP – per capita: $600)

Itsandra at sunset
Population growth and unemployment at a high rate are responsible for the poor economy of Union of the Comoros. Population density at a rate of 1000 per square km in agriculture zones may result in an environmental crisis. Agricultural contribution to its GDP is 40%. The low level of education has raised the level of labor force. Economy mainly depends on foreign grants.

05. Republic of Somalia (GDP – per capita: $600)

“Sixteen million people in eastern Africa are in need of emergency food aid and the threat of starvation is severe, according to FAO’s latest report on the Food Supply Situation and Crop Prospects in sub-Saharan Africa.” – ☠ ● qυєєη σƒ яσ¢к ● ☠
Agriculture is the base of the economy of Republic of Somalia in the Horn of Africa. Nomads and semi-nomads comprise a major part of the population. Rearing livestock is the primary source of livelihood for them. The small agricultural industry contributes 10% to its GDP.
“Mogadishu. October 2004. View of Mogadishu north. Mogadishu is the place where effects of the conflict are more striking. There are arround 400.000 internally displaced persons. Access to health structures is quite impossible for the danger to circulate in the streets where combats are on-going and all type infrastructures have disapeared: water, sanitation, schools… The absence of state during more than 13 years has made impossible any investment in public structures. It is estimated that around 72% of Somalia’s population lacks access to basic healthcare services and the healthcare system is in ruins.” – abdisalla

04. The Solomon Islands (GDP – per capita: $600)

Solomon Islands Tsunami -- Minister whose church was washed away
“Solomon Islands Tsunami — Minister whose church was washed away”
The Solomon Islands is a country in Melanesia. Fishing holds its domestic economy. Above 75% of the labor class, is involved in fishing. Timber was the main product for export until 1998. Palm oil and copra are important cash crops for export. The Solomon Islands are rich in mineral resources like zinc, lead, gold and nickel.

03. Republic of Zimbabwe (GDP – per capita: $500)

“The expression on these guys faces says a million things, weak from hunger and too poor to own shoes or have a shirt to wear. This is all because of the tyrant they call a president.
A beautiful country ruined because of one mans greed. ”
– Mr Sean
Republic of Zimbabwe is located between the Limpopo and Zambezi rivers in the south of Africa. Its economy suffers a slowdown due to supply shortage, soaring inflation and foreign exchange shortage. Zimbabwe’s involvement in the Democratic Republic of the Congo left its economy fragile. The worst consequence of the knelt-down economy is unemployment that is as high as 80%.
“March, 5, 2008. The Zimbabwean currency tumbled to a record 25 million dollars for a single US dollar”

02. Republic of Liberia (GDP – per capita: $500)

Young boy looks through hole in garbage dump
“MONROVIA, LIBERIA – NOVEMBER 12, 2006 : Young Liberian boy standing on Randal street in Monrovia looks through a hole in a garbage filled car that has been turned on its side and salvaged fro spare parts. ( Photo by: Christopher Herwig )” –
Republic of Liberia on the west coast of Africa is one of the ten poorest economies across the globe. A decline in the export of commodities, the flight of many investors from the country, the unjust exploitation of the country’s diamond resource, looting and war profiteering during the civil war in 1990 brought the economy of the country to its knees. External debt of the country is more than its GDP.
Government child soldiers
“Liberia: Government child soldiers,Ganta; on the back of their truck is an anti-aircraft gun. © Teun Voeten, 2003.
Liberia’s decade-long civil war was fuelled by weapons imported in to the country in violation of a UN arms embargo. Shipments over three months in 2002 from a Serbian security company, for example, brought in enough bullets to kill the entire population of Liberia.”
– controlarms

01. Republic of the Congo (GDP – per capita: $300)

Street of Kinshasa
“This picture shows what Kinshasa is: full of contradictions. The beauty of the sunlight, nature, happy people contrasts with the filth on the streets, disorganisation, poverty… These two persons seem to stand there, in the middle of all that. Can they push the country forward… Are they part of a generation that will one day live in a modern Democratic Republic of Congo, freed of all suffering and pain?” – fredogaza
Republic of the Congo in Central Africa is the last at the bottom of the economic heaps. Depreciation of Franc Zone currencies, incredibly high levels of inflation in 1994, eruption of the civil war, and continuation of armed conflict and slumping oil price in 1998 broke down the economy of the country.
Former child soldiers
“A group of ‘kotelengana’, or former child soldiers, in DRC” – War Child UK
GDP – per capita (PPP) 2008 Country Ranks
SOURCE: CIA World Factbook 2008

          State to hike rates on low-income health care plan : Richard Roesler        
State health officials said Monday that they???ve found a way to skirt one of the Legislature???s most heart-rending budget dilemmas: how to yank health coverage from tens of thousands of people.

Instead of trying to decide whose coverage to cut, the state Health Care Authority will instead sharply increase the rates for the state-subsidized insurance. It will also try to shift more people onto Medicaid, which is partly paid for by the federal government.

It???s not a great solution, but it???s the best of the bad solutions,??? said Dave Wasser, a spokesman for the agency.

The move will almost certainly increase the attrition rate, the agency and health advocates agree. But at least those who can find the money won???t be automatically cut off.

Washington???s Basic Health Plan insures nearly 100,000 people statewide, including nearly 7,500 in Spokane County.

They are overwhelmingly working people,??? said Peg Hopkins, executive director of the Community Health Association of Spokane.

The program is intended to cover the working poor, many of whom work for small businesses that don???t offer health coverage. Some 56 percent of those on the program are below the federal poverty level. For a family of 4, that???s $22,050 a year.

The average person pays $36 a month of the cost. Taxpayers pick up the rest of the monthly tab: $205. Advocates argue that it???s much cheaper to subsidize the insurance than to allow health problems to fester until someone lands ??" with no insurance ??" in a hospital emergency room.

The new plan is to boost those premiums to an average of $62 a month, starting in January. The lowest-income people would see their monthly premiums rise from $17 to $34 per person. A higher-end premium for someone earning more would rise from $135 to $201. (To qualify for Basic Health, people must be living on less than 200 percent of the federal poverty level. That???s $42,400 for a family of 4.)

In a year of dramatic cuts to state programs, the Basic Health Plan was one of the most controversial. This spring, cash-strapped state lawmakers decided to cut the program by 43 percent, or about $238 million over two years.

To save that much, health officials expected to drop about 40,000 people from coverage. And that???s not counting the more than 30,000 people on a waiting list to get the coverage.

But how to cut people off their health coverage? Start with the people earning the most money? Those on state coverage the longest? What about women who are pregnant, or people getting cancer treatment? One idea floated was to use a lottery system to determine who can keep health coverage.

Any of those resulted in people being taken arbitrarily off the program,??? said Wasser. Raising the rates, he said, is really the one option that doesn???t do that.???

People are scared,??? said Hopkins. I don???t think anyone can overstate the cost to health of anxiety, of not knowing whether you???ll have access to care. I???ve heard people in the waiting room talking about it.???

Nobody???s pretending that raising the rates won???t drive people off the program. Already, 2,000 to 3,000 people cancel the insurance every month.

For poor people trying to balance health coverage with rent, groceries and gas, an extra $20 or $50 a month per person will increase the attrition, predicted Rebecca Kavoussi, with the Community Health Network of Washington.

This was the lesser of the evils,??? she said, compared to other ways of paring the plan???s costs. At least it allows people, ostensibly, a choice. It gives them more of a say in the matter, instead of just getting a pink slip in the mail saying ??~your insurance has been cancelled.??????

The state also hopes to shift up to 8,000 of the people onto Medicaid. Between that and attrition, Wasser said, the program should be down to about 75,000 people by the end of this year. With the current funding, the state believes it can maintain the program at 60,000 to 70,000 people, he said.

The Health Care Authority also plans to tighten checks to ensure that people on the program meet the income rules, Wasser said.

Republican lawmakers gave the plan mixed reviews. Sen. Cheryl Pflug, R-Maple Valley, praised health officials for doing their best to protect coverage for the most people. But she said majority Democrats should have saved more by acting faster to find efficiencies.

They wasted four months bellowing things like ??~People will die!??? in hopes of justifying tax increases,??? Pflug said. She said the state should have increased health insurance costs for state employees instead.

Instead of asking state employees to pay a little more for their luxurious health insurance, (the Legislature) effectively shifted the premium increase to the poorest of all Washingtonians,??? she said.

Republicans had called for a plan to shift about a third of the Basic Health members ??" those 19 to 34 years old ??" onto a stripped-down core benefit plan.??? Others would get state vouchers, which they could match with employer and individual dollars to find private insurance. Neither plan even got a hearing in the House.

That???s the great failure of this last legislative session,??? said Rep. Doug Ericksen, R-Ferndale.

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          Mercy Health Creates Model for Linking Poor to Healthcare        
As governments gear to bring advanced healthcare closer to remote locations and poor in the society, investments in programs enabling to achieve the goal are rising. In one such effort, the Franklin Avenue Medical Center was held in Toledo’s center city. The center sees attendance from nearly two thousand people seeking medical attention. A majority of them are poor, homless, or already ill. Linda Bert, who is the regional manager for Mercy Health revealed some of the patients visiting the center wouldn’t be alive if they didn’t organize the health center and help the critical patients with proper care and mediction. She further added as majority of the visitors can barely manage two whole meals of a day, it is next to impossible for them to cover medical expenses. Healthcare to them is a form luxury, which they cannot afford. Besides Healthcare, Mercy Health Offers Food and Clothing Assistance Considering economic conditions of the majority of visitors, Mercy Health has arranged a small food and clothing bank to support people with staples besides providing them with basic healthcare facilities. Veronica Cooper, one of the patients visiting Mercy Health said without the service it would have become very difficult for her to manage healthcare expenses. While Veronica is aware of the facilities provided by Mercy Health, several homeless in the community do not know about clothing and food assistance offered by Mercy Health. Furthermore, Tammy Vaughan added that Mercy Health was a life saver, when her husband lost job and with it the medical insurance. She said, Mercy Health made healthcare more convinient and affordable.

Original Post Mercy Health Creates Model for Linking Poor to Healthcare source Twease
          Emerging Markets Learning from Americas Healthcare Mistakes        
Universal healthcare is going through a phase. The New York Times reported on last Thursday a full-page ad was published by The Rockefeller Foundation, announcing its support for 267 economists from across forty-four countries, who have been voicing that economically-efficient universal health coverage policies should be drafted in no time. The declaration found support from many famous signatories, among whom was Larry Summers the former Treasury Secretary, who also wrote in Financial Times op-ed, that providing universal health coverage could surpass the expenses by a factor of ten.   Relatively poor economies are exhibiting a healthy pace of delivering basic healthcare to their citizens. According to the latest reports, countries such as Indonesia, that has a GDP of roughly US$3,500 per capita vs the US$53,000 per capita of the United States, have already launched ambitious strategies to achieve universal coverage by the end of 2019. Likewise, the middle-income countries such as Saudi Arabia, Costa Rica, and Brazil already have universal health coverage for their citizens.  The U.S., who has remained at the forefront of economic development, against the backdrop of universal health coverage seemed laggard compared the emerging economies. Despite the impressive success of Obamacare in reducing the number of Americans without health coverage, 10.4% of the country’s people that roughly adds up to 33 million people, still remains uninsured. With the rise in healthcare costs has significantly reduced in the recent years, the United States government is projected to spend 20% of its GDP on healthcare developments by 2024.  The latest studies have revealed that rising healthcare costs is one of the biggest obstacles to the success of entrepreneurs in the country. As a result, this impacts the availability of healthcare sponsored by the government in the U.S. While Obamacare reforms may have triggered some strides in the country’s healthcare sector, but small accidents in the country’s historical past will make a big impact on the evolution of the U.S. healthcare industry.

Original Post Emerging Markets Learning from Americas Healthcare Mistakes source Twease
          Trust Women Week and the San Francisco Banner Project        
The majority of Americans believe that women should have access to basic health care services and that decisions about reproductive health care including family planning and abortion should be left...

Health reform: positions for progressives. Taking action today to build for tomorrow. See for more.

          Gender gap helps Obama        

Women have comprised a majority of the eligible electorate since 1964, and also hold another advantage because, proportionately, they vote more than men.

According to a few recent polls, this may be why Obama could very possibly be re-elected next November. The USA/Gallop Poll gives Obama an 18-point lead in key battleground states. His advantage in 2008 was 12 points, so he is ahead of that historic year. Both the NBC/Marist poll and the Quinnipiac poll also show him with a good lead over Romney, who is the obvious choice for the Republicans this year.

It can’t come as a surprise to anyone that women prefer Obama — because it seems to me that no woman in her right mind would vote for a Republican this year. The old Republican Party is gone, and the new radical one wants to take us back to the 1950’s or earlier. I don’t mean that women who vote for Republicans are crazy, just that they must have a very distorted view of themselves. After the ridiculous anti — women antics of the Republican Party this past year, why would any woman want to give a bunch of old, white men control over her body and her life? Why would any woman listen to anyone, whether a priest, pastor, husband, friend, or politician more than she listens to herself? Why would she vote against her own self-interest, her own health, her own future. Well, apparently she wouldn’t.

The gender gap is greatest for women under 50, so maybe the past decades of more equality for women is working. Most women can clearly see that things are better now than they were four years ago. Maybe not as good as they would like; the progress has been slow, but at least steady. But to lose all the gains they have made would change the lives of women in a very negative way. It would hurt their families as well. Lots of women without access to basic health care, preventive care, contraception, choice of controlling their own bodies — maybe this would take us back to another century, not just a past decade.

So for women this is an extremely important election. They need to not only vote, but work for the candidate they hope will be president. And that is Obama. Men, of course, will work with them. This election will be a test about how much an election can be bought. Since Citizen’s United that will be an important factor. We will have a chance to see if people power can outperform money power. And women will be one key to that answer. Their energy, their beliefs, their commitment can provide us with a society that will have concern for the common good.

It’s going to be a long, hot summer and a long fall as well. The future of what we want our country to be is on the line. The contrast between the two visions is stark. It is especially stark for women. They can not afford to sit back this year.

I hope next November we will see the re-election of a great president who cares about all the people of this country. One who has done everything in his power to create a better country, and who is respected around the world. Women can make this happen. And they are happy to have men as partners in this endeavor. So let’s do it — let’s show the country that they can’t discount women. We deserve better than that.

Columnist Barbara Kelly can be reached at

Content Watch Publication ID: 

          Venezuela’s Sinking Boat        

Venezuela's President Nicolas Maduro (C), his wife Cilia Flores and Diosdado Cabello, deputy of Venezuela's United Socialist Party, attend the closing campaign ceremony for the upcoming Constituent Assembly election in Caracas, Venezuela July 27, 2017.

© 2017 Reuters

In the middle of the night on August 1, intelligence agents burst into the homes of Leopoldo López and Antonio Ledezma, two Venezuelan opposition leaders who were under house arrest for trumped up charges, and took them away. The Supreme Court, a puppet of the executive branch, said the men had violated conditions for their house arrest by making public political statements and alleged that they were planning to flee, without providing any evidence. Their families did not know their whereabouts for several hours. López and Ledezma are both reportedly being held at the Ramo Verde military prison.

When President Nicolás Maduro defended his illegitimate Constituent Assembly, he said it was necessary to restore “peace.” Is this the “peace” he had in mind?

These arrests are only the latest evidence that what Maduro really wants to do is crush dissent and impose a dictatorship. That evidence has been growing every day for months. Massive protests have been met with a brutal crackdown in which security forces have shot demonstrators at point-blank range with riot-control munitions, run over demonstrators with an armored vehicle, brutally beaten people who offered no resistance, and broken into homes of suspected opponents. More than 120 people have died in the context of anti-government demonstrations, most of them at the hands of security agents or pro-government armed groups, according to the Attorney General’s Office.

Hundreds of demonstrators, bystanders, and critics have been arbitrarily arrested. More than 460 civilians have been prosecuted in military courts, without any due process, for crimes including rebellion or treason.

Meanwhile, the government has failed to address the food and health crises it faces. It hasn’t done enough to secure aid that could alleviate the suffering of many Venezuelans who cannot get adequate nutrition or basic health care for their families. Hundreds of thousands of Venezuelans have fled their country.

In spite of the danger, many Venezuelans continue to take to the streets and express their discontent. They risk losing their government jobs, or access to food sold under government price controls. Dissent has emerged even at the upper echelons of the government—the attorney general, former government officials and pro-government legislators, and even members of the military are distancing themselves from the abuse. Whether they act out of conviction, or to save themselves when the boat is sinking, the reality is that fewer and fewer people are willing to stay on board.

The world is also standing up to Maduro, offering an increasingly unified front of condemnation. Key heads of state have already said that they would not recognize the Constituent Assembly, have spoken out against the regime’s abuses, and have called on the Venezuelan government to release political prisoners. The OAS has an ongoing discussion regarding Venezuela’s compliance with the Inter-American Democratic Charter, in which a majority of governments have expressed concern about the situation in Venezuela. Some have moved from words to action—the United States, Mexico, and Colombia have imposed or committed themselves to imposing sanctions on key Venezuelan officials, including cancelling visa and freezing assets.

The Venezuelan government, as expected, has played the sovereignty card, accusing its international critics of interfering in the country’s internal affairs. But that argument is tired and ridiculous; sovereignty doesn’t make an abusive government immune from criticism and protest—or from consequences.

The most recent arrests are tactics to intimidate opposition leaders and critics. Maduro is testing how far he can go—and this challenge should be met with a very robust reaction.

The international pressure should continue, and there are many ways it might materialize. The Mercosur regional trade bloc is considering expelling Venezuela due to its violation of regional human rights and democracy rules, and foreign ministers from the region are meeting in Lima on August 8 to discuss Venezuela’s crisis and additional measures to take. Key international leaders should adopt targeted sanctions against key Venezuelan officials implicated in egregious abuses, and send a clear message that those responsible for abuses should eventually be brought to justice when judicial independence in Venezuela is restored. All of this should contribute to dissuade officials from violating basic rights in the future.

As it becomes clearer and clearer that there is much to be gained from a peaceful transition back to democracy, and much to be lost from continuing to walk the destructive path Maduro has embarked upon, more and more people will jump off the government’s sinking boat.

          Venezuela is Imploding. These Citizens Were Desperate to Escape.        

A demonstrator is detained by security forces during clashes at a protest against Venezuelan President Nicolas Maduro's government in Caracas, Venezuela, July 10, 2017. 

© 2017 Reuters

Anacelis Alfaro’s troubles started late last year in the main plaza of Barquisimeto, the quiet capital of Venezuela’s Lara state, on the banks of the Turbio River. Alfaro, 51, was an event organizer for a private university there — and an activist for an opposition political party, Popular Will, in charge of organizing working-class neighborhoods throughout Lara. On a sunny day last December, the party was celebrating its anniversary fiesta in the town square. Alfaro’s keynote speech celebrated the role of women in politics, mentioned the arbitrary jailing of opposition party leader Leopoldo López, and urged hope in grim times. She basked in the December sunshine, catching up with activists from various states, and went home without a clue that life as she knew it was over.

The next day, a criminal judge issued a warrant to search the homes of two party activists for “posters and signs” and “other evidence of criminal interest.” Alfaro, unaware that her apartment was on the list, was visiting friends for the weekend in neighboring Carabobo state. So when the police arrived in the small unit, only her 79-year-old mother, who lived with her, was there to see them ransack the place and to answer questions about Alfaro’s whereabouts.

The warrant did not specify a crime, but a friend with links to the government warned Alfaro to stay away from home. Officers who had interrogated the other activist for two days asked repeatedly where Alfaro was. So she spent a week hiding with friends before taking their advice to flee the country. A friend fetched her passport, and Alfaro flew to Buenos Aires, where, after months of getting her papers in order and seeking work, she found a job making sandwiches in a fast-food restaurant in Argentina’s capital — exiled for the crime of dissenting. “I felt like a coward,” Alfaro said when I met her in the cafe. But, she added, “In jail, I am useless.”

The scale and brutality of violent repression by Venezuelan security forces is evident in video footage shot in recent months, Human Rights Watch said in a multimedia piece released today. 

As Venezuela transforms into a police state, hundreds of thousands are fleeing hardship and persecution. Historically, this country welcomed immigrants, including many who escaped the Latin American dictatorships of the 1960s and 1970s. (Arrivals from Argentina, Chile and Uruguay increased by 800 percent during that period — a wave that included my parents, who fled Buenos Aires days before the 1976 military coup.) But now the pipeline moves in the opposite direction, and countries around the region are scrambling to return the favor.

I’ve interviewed dozens of people from the new Venezuelan diaspora in recent months, including professionals, students and members of indigenous communities who left the country by plane, like Alfaro, or on days-long bus rides, or even on foot. They fled in search of food, medical treatment or shelter from persecution. Argentina has more than doubled the number of temporary resident permits issued to Venezuelans every year since 2014, reaching 35,600 in May 2017, according to Argentine immigration authorities. Chile has more than quadrupled its visas to Venezuelans in recent years, from 1,463 in 2013 to 8,381 in 2015. Peru has received more than 10,000 Venezuelan requests to stay so far in 2017, immigration authorities told Human Rights Watch.

Venezuelans were sixth on the 2014 list of countries whose nationals requested legal residency permits in Uruguay, but they jumped to the first place this year, authorities told Human Rights Watch. Brazil has a backlog of thousands of Venezuelan asylum applications, and Venezuela last year sent more asylum seekers to the United States than any other country (some 18,000, according to reports).

Each of my interviewees gave new meaning to the depth of the political and economic collapse.

Hunger forced Pablo López, a 23-year-old member of the Venezuelan Warao indigenous community, to cross to Brazil. When I interviewed him in February, he was sleeping on the street in a Brazilian border city with 100 of his fellow Warao. Men, women and children lived, cooked and ate in extremely unhygienic conditions there. López earned $1.40 an hour loading trucks. Other members of his community sold handicrafts or begged on the streets. Everyone I spoke with told me they were better off in Brazil than in Venezuela.

Cancer forced out Ludiskel Mass, a 32-year-old schoolteacher and student activist with the opposition party, A New Time. Doctors in her hometown of Maracaibo told her in 2015 that vaginal bleeding was probably caused by a cyst, but they lacked the medical supplies to provide a proper diagnosis. Two friends paid for her bus ticket to Lima, where she arrived after a six-day road trip, she told me. In Peru, doctors diagnosed her and operated successfully to remove a uterine cancer. A year later, she moved with her 11- and 12-year old children to Lima.

Alfaro is sure she would be in prison if she hadn’t run. Many activists — the powerful and well-known, as well as the low-profile — have been harassed, detained or threatened with arrest since she fled. Venezuelan Penal Forum, a nonprofit group, counts about 400 political prisoners, and says that, since April, military courts have prosecuted more than 460 civilians, over whom such courts are supposed to have no jurisdiction.

On July 16, more than 7 million Venezuelans participated in an unofficial plebiscite organized by the opposition with the support of civil society groups, universities and hundreds of volunteers. With their participation, they expressed their opposition to President Nicolás Maduro’s proposal for a Constituent Assembly made up of government supporters. About 10 percent did so from abroad. (Two weeks later, Maduro went ahead with his plan anyway, erecting a Constituent Assembly with frighteningly wide and vaguely defined powers for an indeterminate amount of time.)

Whether they were fleeing privation or imprisonment, all the people I interviewed thought they’d had no choice but to leave. In Venezuela today, there are no independent institutions left to check executive power. The supreme court, which became an appendix of the Miraflores Palace after former president Hugo Chávez stacked it in 2004, has repeatedly upheld measures that erode Venezuela’s democracy and violate fundamental rights. Recently, the court stripped the National Assembly of legislative powers — and instead of insisting on Maduro’s adherence to the constitution, the court supported his call to rewrite it. It also rejected every legal challenge brought by Attorney General Luisa Ortega Díaz, a former government loyalist who has begun to speak out against the government. The National Electoral Council, likewise, failed to carry out regional elections that the constitution mandated for 2016 and delayed a referendum to recall Maduro — until the courts shut down the recall effort entirely.

The Maduro administration has taken advantage of its monopoly on power to arrest and prosecute critics, to disqualify opponents from running for office — and jail them for good measure — to detain or expel journalists, and to take TV channels off the air. Venezuelan security forces, together with armed pro-government groups, have brutally repressed massive anti-government protests, killing dozens, injuring hundreds and detaining thousands.

Hernán González, 40, told me recently in Uruguay that he fled Venezuela after the National Guard killed his brother, Pablo. For years, he and his family had been hardcore chavistas, but they had soured on the regime because of food lines and malnutrition; they voted for the opposition in the 2015 legislative elections. One evening in November 2016, witnesses told González (which is not his real name), that Pablo was playing dominoes with friends on the sidewalk near his home when guardsmen detained him. Later that evening, Pablo’s body turned up at a hospital; members of the National Guard told González his brother had died in a “confrontation.” The body was covered in bruises had a bullet hole in the chest.

The government has also denied a humanitarian crisis resulting from a mishandling of the country’s economy, and has refused to seek readily available international aid. So severe shortages of medicine, medical supplies and food drive out more and more people like López and Mass, who cannot feed their families or get the most basic health care. And the cycle of government repression and denial continues. Days after the health minister reported 2016 figures showing skyrocketing maternal mortality, infant mortality and malaria cases, she was fired.

The South American nations giving refuge to Venezuelans have opened a pressure valve — albeit a small one — on the crisis. But exile is no permanent solution. The problem is the Maduro administration’s abusive policies and practices. Since thousands of Venezuelans took to the streets in early April to protest its growing authoritarianism, the government has responded with a brutal crackdown. Security forces have shot demonstrators at point-blank range with riot-control munitions, run over demonstrators with an armored vehicle, beaten people who offered no resistance and broken into homes of suspected opponents. The security forces have also arbitrarily arrested hundreds of demonstrators, bystanders and critics.

The region’s leaders need to redouble pressure on Maduro to set a date for free and fair elections with rigorous international oversight. They need to keep pressing him to end the repression, release all political prisoners, prosecute human rights crimes, restore judicial independence, reinstate the powers of the National Assembly and allow an ample flow of international aid. They need to impose sanctions against key officials and signal that human rights violators will eventually be brought to justice — once judicial independence is restored in Venezuela.

The people in prison for dissenting, the people going home empty-handed from bread lines and the people ailing with preventable diseases deserve as much. So do the exiles who are longing to return to their country.

Alfaro is getting used to Buenos Aires. She likes strolling the city, which she couldn’t do in her crime-ridden country. She has friends among the migrant Venezuelans, and although she was grateful to learn restaurant work late in life, she is happier now that she found a job using her Caribbean charm to sell jewelry in Buenos Aires. She collaborates with Venezuelan opposition members who travel to Argentina, and she ran one of the centers in Buenos Aires for the opposition’s July 16 plebiscite, so she knows she is contributing to restoring democracy in Venezuela. But at the deepest level, she feels homesick and disenfranchised. “I will eventually go back to my country to help rebuild it,” Alfaro said as we gathered our things to leave the cafe.

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          Health of children who grow from Developing Countries        
For a child, the current scenario regarding child health in developing countries around the world is not pleasant. Data shows, that every second a child in a developing country suffers from malnutrition, and roughly 60,000 children born with HIV yearly. In some countries, even basic health care facility and health assurance appear to be a dream for the greater part of the population. It has been observed that children belonging to under the age of […]
          A Rhetorical Analysis        
A Rhetorical Analysis of the Discourse of
Advertising Herbal Medicine in Southwestern Nigeria
Adeyemi Adegoju (Ile-Ife)


The present researcher grew up in southwestern Nigeria, as an elementary school pupil in the late 1970's, to the consciousness of the advertisement of herbal medicine at strategic locations such as roadsides, markets and motor parks in major towns and cities where the attention of passers-by could easily be attracted. A major channel of reaching the prospective consumers at such settings was the suspension of blaring loudspeakers on the top of stationary vehicles. Although this advertising channel still subsists, a new trend in the advertisement of herbal medicine in modern times is the aggressive marketing drive in both the print and electronic media. Commenting on this, Komolafe (1998: 71) writes:
In recent times, a lot of interest and attention have been drawn to the curative claims and norms (ethics) of Traditional Medicine practitioners in Nigeria. Curative claims by herbalists and Traditional Healers have been headline news in our print and electronic media [...].

This innovation is remarkable in certain respects. First, it resonates with the revival of interest in herbal healing in modern-day health care delivery. Second, the choice of the mass media channels of radio, television and news magazines as opposed to the traditional channel of reaching only a limited number of audiences is a welcome development in the bid to raise the level of awareness on the place of herbal therapy in modern health care delivery. In the light of the foregoing, this study calls attention to a vexed question that has generated so much interest among scholars (cf. van der Geest 1997, Offiong 1999, Olson 2006 and Iroegbu 2006). While these scholars, among others, focus on the place of herbal medicine in basic health services, little or no attention is paid to the rhetorical style of herbal medical practitioners in launching their products. It is against this backdrop that this article examines the deployment of persuasive techniques to launder the image of herbal medical practitioners and affirm the efficacy of their products, on the one hand, and to negatively label orthodox medicine and its place in the health care system, on the other hand.

It is useful here to sketch out the rest of the study. After this introduction, we provide information on the data sampled for the study. We then proceed to give an overview of the art of herbal healing. Next, we highlight the rhetorical principles that underpin the study. It is on this note that we go ahead to exploring the rhetorical dynamics of the therapeutic discourse of marketing herbal medicine. Finally, we give the concluding remarks of the study.

The Data

The data sampled for this study span both the electronic and print media. For the electronic media, we focus on jingles on radio and television. Apart from such jingles, we also consider special programmes where the advertisers buy airtime that covers at least a quarter-hour or a half-hour slot. Such programmes sometimes involve interview sections where the advertisers field questions from presenters and in some cases the advertisers do the talk alone. The jingles and sponsored programmes are drawn from radio and television stations based in the southwestern Yoruba-speaking states of Nigeria. This delimitation is not an attempt to single out the healing culture of a particular ethnic group for discussion or promote it over and above the healing cultures of other ethnic groups in Nigeria. It is noteworthy that the advertisers sampled in this study would rather pride on their products being of African origin than attempting to whip up ethno-cultural sentiments within Nigeria. Thus, the appeal to a larger trans-national (African) identity even in the national news magazines where we have selected paid advertorials clearly sets the tone for the rivalry between traditional African medicine and conventional western medicine. In this regard, Kayode (2006: 44) posits: "Health care systems differ from one society and from one age to the other. The most obvious differences can be observed between the western health care system and the traditional African system."

As to the sample data from the print media, we use select paid adverts in national news magazines – Tell and The News – where the advertisers of herbal medicine seem to have preference for advertising their products. It is interesting to note, however, that there is a considerable degree of overlap between the advertisements across the print and electronic media so much so that focusing on one for analysis would not detract significantly from the patterns of discourse functions which generally characterize the data from the two media. On a final note, we specify the range of the diseases which the herbal medical practitioners claim to have cure for. Such diseases include obesity, diabetes, asthma, arthritis, fibroid and low sperm count. Others are infertility, sexually transmitted diseases (STDs), epilepsy, tuberculosis and prostrate, among others. Having made these basic clarifications, we will have an overview of the art of herbal healing.

Herbal Therapy

Herbal healing is almost as ancient as history itself, as the knowledge acquired in the field of natural medicine has been passed down through the generations and survive to this day (Morgenstern 2002). Herbal healing is a system of medical treatment in which various parts – leaves, barks, roots, seeds, fruit, latex and resin – of different plants are used in order to treat symptoms and promote good health.

Although there are no written records of the origin of herbal practice in Africa south of the Sahara, there are several legends that have been passed down from generation to generation primarily through oral means. Different ethnic groups in Africa have their own legends about the origin of herbal medicine in their own societies. Babalola (2003) draws on a Yoruba legend which explained that the first man to practise the art of herbal healing was Orunmila who was endowed with this knowledge by God.

The use of herbal medicine has reached an advanced stage in Asia. In China, for instance, herbal treatment has attained a high level of scientific and technological formulation 1. This is a great challenge to herbal medical practitioners in other parts of the world, especially those in Africa. To this end, Olapade (1998: i) argues:
There has been a global resurgence of interest in Traditional Medicines in the last ten years probably because many of the known synthetic drugs in allopathic medicines for the treatment of various ailments are failing or that the causes of these various diseases are developing resistance to the known drugs.

Little wonder then that a new class of herbal medical practitioners has emerged in Nigeria, professing to be well talented, educated and versatile in formulating and modernizing herbal medicine. They also claim that their activities have been under control and monitoring by relevant bodies such as the Nigeria Natural Medicine Development Agency and National Agency for Food and Drugs Administration and Control. With this background information, we now highlight the basic tenets of the rhetorical theory that underpin our analysis.

Theoretical Model

Studies in persuasive speaking basically require an exploration of the art of rhetoric. With close reference to the advertising industry, we posit that the principles of rhetoric in persuading the audience to act or think in the desired manner of the advertiser are noteworthy. Thus, we explicate Aristotle's work on rhetoric which was a remarkable departure from earlier works. Such earlier works had neglected the all-important subject matter of proofs and confined themselves chiefly to appeals to the emotions and things irrelevant to the subject. Aristotle's contribution to the art of rhetoric marked a systematic and scientific orientation to the rhetorical theory (Freese 1959).

Aristotle defined rhetoric "as the faculty of discerning the possible means of persuasion". The speech, according to Aristotle, can produce persuasion either through the character of the speaker (ethos), the emotional state of the listener (pathos) or the argument (logos) itself. Rapp (2002) explains that the persuasion is accomplished by character when the speech is delivered in such a way as to render the speaker worthy of credence. He further explains that the success of the persuasive efforts depends on the emotional dispositions of the audience. Thus, the orator has to arouse emotions because emotions have the power to modify our judgements. Finally, the rhetor persuades by the argument itself when he or she demonstrates or seems to demonstrate that something is the case.

Aside from the three means of persuasion, there are three kinds of rhetorical speeches, deliberative, forensic and epideictic. In the deliberative kind of speech, the speaker either advises the audience to do something or warns against doing something. Rapp further explains that accordingly, the audience has to judge things that are going to happen in the future and have to decide whether they will cause advantage or harm. The forensic speech either accuses somebody or defends self or someone. Naturally, this kind of speech treats things that happened in the past. In the final analysis, Rapp (2002) explains that while the deliberative and forensic species have their context in a controversial situation in which the listener has to decide in favour of one or two opposing parties, the third species does not aim at such a decision. The epideictic speech praises or blames somebody, as it tries to describe things or deeds of the respective person as honourable or shameful.

A persuasive speech, we must emphasize, always occurs in a situation where two or more points of view exist. According to Lucas (1992: 309), "there must be a disagreement, or else there would be no need for persuasion". Given this viewpoint, persuasive speeches centre on four types of arguments or propositions: propositions of fact, value, policy and concern about a problem. O'Hairr et al. (1975: 581–582) explain that propositions of fact assert that something is true or false; propositions of value allege that something is or is not worthwhile; propositions of policy recommend a course of action or policy as necessary and desirable (or unnecessary and undesirable); and the speech designed to create concern about a problem asks an audience to agree that specific conditions should be perceived as a problem requiring solution. We must, however, drop the hint that the classification into these categories is often eclectic as a topic in one category could easily be made to fit into another.

Granted the sensitive and universal nature of the concepts of health, disease and (type of) healing in human life, the propositions or arguments described above predominate the persuader's intent to modify, influence, shape and (if possible) change the beliefs, attitudes and behaviour of the audience as we shall see presently in our discussion.


One of the rhetorical strategies employed in advertising herbal medicine in the discourse is source credibility. The advertisers appear to be credible by displaying practical intelligence and knowledge of herbal healing. While attempting to propagate their credibility, they reel off the symptoms of diseases, while on air, in such a clinical manner that the viewer/listener cannot but marvel at the depth of their erudition. Worthy of note is the way the herbal physicians pontificate, giving the impression that they are well versed in pathology and could, therefore, diagnose the patients' diseases even before interacting with them one-on-one.

This is a rhetorical strategy geared not only at convincing the audience of their competence but also at refuting the perceived opponents or critics of herbal medicine who negatively label herbal medical practitioners as local, shallow and illiterate. In fact, some of the advertisers refute their opponents by claiming that they embark on research activities before formulating their drugs, that they possess certain specialized equipment and other laboratory facilities for diagnosing patients' diseases and that they repackage their products in form of tablets, capsules and syrups. These claims have some rhetorical effects. First, the advertisers seek to emphasize their own methods of herbal healing which are backed by scientific proof and, therefore, have diverged from the traditional methods of herbal preparations such as concoction, decoction, infusion, powder and dried herbs mixed with food. Second, they serve to demystify contemporary herbal healing as being devoid of ritual/occult practices and divination. Finally, the advertisers try to strike a parallel between the practices of herbal healing in Africa with advances in Asian countries like China and India, on the one hand, and with western medicine, on the other hand. This is an example of a parallel case argumentation in which comparisons are drawn between two entities to underscore areas of similarities or dissimilarities.

In order to further make themselves worthy of credence, the advertisers try to appeal to wide geographical spread. Those with limited airtime on radio and television may not be able to read out where all their offices or clinics are located. So, they use such spatial deictic forms as "different locations in Nigeria" or "across the nation", "worldwide", "within Nigeria and overseas". In the news magazine, however, there is the display of plethora of addresses that span major cities and towns in Nigeria. In some cases, some of the advertisers claim to have offices/clinics in London, the United States of America, Switzerland, and so on. Moreover, some claim to have been connected to the global village by displaying their websites on the Internet. All of these claims tend to underscore the herbal practitioners' quest for acceptability.

Besides the strategies above, the advertisers attempt to establish credibility by answering such appellations as "Dr", "Prince" and "Chief". As regards the use of "Dr", the advertisers try to draw a parallel between themselves and the practitioners of orthodox medicine, particularly in Nigeria, who are identified with the title 'Dr'. The use of this title generally suggests that the bearer is competent in the diagnosis and treatment of ailment. Therefore, the title confers legitimacy on the herbal medical practitioners as specialists that have undergone training in the art of herbal healing and can, therefore, be entrusted with human life. On the contrary, the use of "Chief" and "Prince" in a traditional society has some implications. Chiefs and Princes are supposedly men of honour and integrity who can be entrusted with great responsibilities in society. The rhetorical factor that is brought to bear here is 'character' which is described by Lucas (1992: 326) as "how an audience regards a speaker's sincerity, trustworthiness, and concern for the well-being of the audience".

In some instances, the use of the titles is closely linked to the advertisers' pride in their pedigree in the art of herbal healing. The advertisers usually claim to have inherited the art from their grandfathers or fathers whose healing artistry was extolled as being unrivalled in their days. This is a case of rhetorical appeal to "hereditary endowment" for any trait that is inherited is generally believed to be more enduring than that which is learnt.

All in all, the trail-blazing or landmark efforts that the advertisers claim to have made in their own rights in the bid to chart a new and noble course for herbal therapy is summarized in slogans and catchphrases that are attached to their herbal homes. The following are examples:
Yemkem International: The Pathfinder and Leading Name in Curative Medicine
Ayodele: The Pioneer in African Naturopathic Medicine
Kolaq: The Pacesetter

Rhetorically, the use of the nominals "pathfinder", "pioneer" and "pacesetter" suggests that herbal healing has been transformed and that some personnel is in the vanguard of the innovation. In addition, the use underlines the kind of rivalry that thrives even among the herbal medical practitioners and the attempt made by each of them to project self as "first among equals".

Appeal to motivational proof also serves some rhetorical functions in the discourse. O'Hairr et al. (1975: 585) argues that "at the heart of persuasion is the ability to adapt a message to the feelings, needs, and values of an audience". Advertisers create some needs that the audience would certainly like to meet. In the present discourse, playing on the audience's emotions, especially the desire for things as they used to be is apparent. The advertised herbal product is usually presented as capable of restoring people to their former state of health. This is particularly the hub of the advertisement of herbal medicine when we consider the inevitable transitoriness from sound health to a diseased condition for which the patient would naturally desire healing.

The advertisers' bid to launch herbal medicine as an antidote in restoring normal health, especially where conventional medicine has supposedly failed is interesting. Consider the following excerpts:
Many victims complain of having visited several hospitals and clinics yet could not get cure for their staph. The reason is that they did not use right medication in the first place. Such people use antibiotics and injection which can hardly cure staph aureus but suppresses it because the herbal medicine is the best for it.

(The News, February 14, 2005: 9)

Herb and root are the best treatment to avoid re-occurrence, [sic] because it cannot be cured with ejection [sic] or any antibiotic only. Because this bacteria's [sic] called staphylococcus have developed resistance to all form of western antibiotics.

(The News, July 25, 2005: 9)

In the above extracts, the advertisers use the "We are different and unique" claim which, according to Schrank, "states that there is nothing else like the product being advertised". Schrank further explains that the claim is supposed to be interpreted as a claim to superiority. Here, the advertisers juxtapose both orthodox healing and herbal healing methods and ascribe a claim of superiority to the efficacy of herbal therapy. This attempt lends credence to the spirited touting of herbal products as 'alternative' therapy to orthodox medicine. This claim brings to bear a dominant propaganda technique in advertisement known as 'compare and contrast' where the viewer/listener is led to believe that one product is better than another although no real proof is given.

One would expect that the present discourse that makes health or safety claims would be supported by competent and reliable scientific evidence that has been evaluated by certain personnel or bodies qualified to review it to prove where, how and why orthodox medicine has failed, on the one hand, and where, how and why herbal healing makes up for the inadequacies, on the other hand. That the advertiser in the first extract above draws on the statements of patients dissatisfied with orthodox medicine – "Many victims complain of having visited several hospitals and clinics yet could not get cure for their staph" – is not sufficient to support a health or safety claim that requires objective evaluation. It must be hinted, at this point, that Nigeria is such a society where people abuse drugs a lot by just walking up to a chemist to buy drugs on self prescription and even when medical assistance is sought, quacks could have been consulted. Statements obtained from such patients would not be sufficient, therefore, to disprove the efficacy of orthodox medicine. The claim that herbal medicine is the best treatment is not convincing moreso that the word "best" belongs to the class of words referred to as 'glittering generalities' commonly used in advertisements. Glittering generalities are important-sounding 'glad words' that have little or no real meaning and when they are used, they demand approval without thinking simply because such an important concept is involved. This takes us to another common propaganda strategy used in advertisements referred to as 'assertion'. An assertion is an enthusiastic and energetic statement presented as a fact, although it is not necessarily true. So, by claiming that herbal therapy is the best without providing evidence for this, the advertisers are using an assertion, in the hope that the subject would simply agree to the statement without searching for additional information or reasoning.

Apart from labeling orthodox medicine negatively, orthodox medical practitioners are also sometimes portrayed in inhuman and unprofessional images by the advertisers of herbal products. Consider this utterance culled from a herbal home's advertisement: "From now on, no doctor can sentence you to death". Naturally, a doctor supports life as a demonstration of his/her human feelings and professional ethics. But since doctors that do not use herbal products supposedly find it difficult to cure certain diseases, the advertisers of herbal products malign them in a most disparaging image of sentencing innocent people to death in the hospital (a place where life should be saved as opposed to a law court where convicted criminals are sentenced to death by the judge). This apparent transposition of actions across divergent fields makes the attack message a forceful one. This is a propaganda technique known as 'name-calling', as negative words are used to create an unfavourable opinion of orthodox medical practitioners in the audience's minds. Meanwhile, the herbal medical practitioners put up a messianic posture in expressions like: "There is permanent cure for your diseases"; "Fibroid. No operations simply take our herbal products"; "All treatments with natural herbs without side effects." These utterances also bring to bear another propaganda technique called 'euphoria'. It is the use of an event to generate happiness or euphoria or to boost morale.

In doing so, the advertisers employ the advertising trick called the black/white fallacy. According to Taflinger (1996a), a common way in which this trick is used in advertising is by presenting two situations, one with the product and the other without. The one with the product shows circumstances that the advertiser presumes the target audience would like to be in, and vice versa for the situation without the product. For instance, in the above extracts, the situation with the herbal products promises relief from the worries and pains of perceived incurable diseases and gives hope of cure. In particular, the claim that the advertised herbal products have no side effects is not medically convincing. Speaking generally, every drug that is exogenous to the body system has the tendency to cause certain reactions in the system. There have been reported cases of people reacting to 'ordinary' food such as beans and maize, and even vegetables. By genetic variations, there could be some idiosyncratic reactions; what patient A does not react to may cause adverse reactions in patient B. Therefore, the claim by herbal practitioners that their herbal medicine has no side effects may not be true if the particular drugs about which the statement has been made have not been put to clinical trial and subjected to peer review whereby feedback from patients would be objectively considered. Even the medical parlance 'side effect' among experts is no longer popular, as the expression 'adverse effect' is more scientifically defensible; for every drug has side effect(s) but there are degrees of the effect(s) up to the level to which some could be described as adverse.

Evoking pride in one's origins or cultural heritage is a strand of the motivational strategies in the discourse. The advertised herbal products are usually identified as indigenous African products and they need to be so patronized to affirm the consumer's sense of pride in locally made products. This is a solidarity-engineering technique to bolster up the feeling of in-groupness in the Us (African) group while trying to stir up feelings of disenchantment with the Them (Western) group. Let us consider the following:
It's a new dawn in Africa [...] Times have changed. Africa has come of age. With Ayodele Clinics and the power of African medicine, there are no mysteries about ailments anymore in Africa.

(Tell, August 29, 2005: 15)

Here, there is the use of the propaganda technique of appeal to prejudice, as emotive terms are used to attach value or moral goodness to believing the proposition. The sense of pride evoked here is tied to the origins of the products. In fact, in the extract above, the herbal medical practitioner has to coalesce his own identity (personal) with that of a larger cultural (African) identity for acceptability. The advertising strategy used here is called genetic fallacy. It makes a prediction about something based on where it came from or its origins.

We must, however, be wary of instances of the abuse of this strategy as evident in the following extract:
African ailments are born out of African
problems which need only African solution.

(Tell, March 7, 2005: 17)

The extract above, though found in an advertising discourse, bears a striking semblance of claims in postcolonial writings in African Literature where postcolonial writers strive to debunk Eurocentric universalism which takes for granted both the superiority of what is European or Western, and the inferiority of what is not. Such a statement would then be made in an attempt by the colonized people to find a voice and an identity in an attempt to reclaim their own past and then erode the colonialist ideology by which the past had been devalued. However, granted the cross-cultural interactions within the contact zone of the now globalised world, 'cultural polyvalency' would be more beneficial to humanity as opposed to the politics of polarity. This takes us to the concept of 'hybridity', one of the most disputed terms in postcolonial studies. The term 'hybridity' has been most recently associated with Homi Bhabha. In his piece, "Cultural Diversity and Cultural Differences", Bhabha argues that all cultural systems and statements are constructed in what he calls the "third Space of Enunciation" where claims to the inherent purity and originality of cultures are "untenable". Thus, Elizabeth Laragy argues that "Bhabha urges us into this space in an effort to open up the notion of an inter national culture 'not based on exoticism or multi-culturalism of the diversity of cultures, but on the inscription and articulation of culture's hybridity'" 2. Thus, claiming that African problems require only African solutions is in furtherance of the racial practice of cultural exclusivity.

With close reference to the argument put forward in the extract in question, there is the error of hasty generalization in lumping together all ailments as African here. Come to think of it, are obesity, hypertension, fibroid, diabetes mellitus, infertility and the like which the advertisers claim to have cure for really African ailments? Medically, it has been proved that ailments which can be said to be truly African are malaria which is commonly found in the tropics and sickle cell anaemia which is typically African by genetic composition. Thus, if these diseases have been specifically mentioned as African ailments and, therefore, African problems for which the herbal medical practitioners are proffering solutions in the African way, the argumentation will be quite valid.

Undoubtedly, it has been discovered that there could be some ailments in the African environment that have proved resistant to synthetic drugs. The success of African Traditional Medicine in such areas where the orthodox medicine has failed has been emphasized by Olapade (1998), Babalola (2005) and Kayode (2006). This is a much-touted opinion in the discourse of advertising traditional medicine in the bid to underlie its place in making up for the so-called inadequacies of orthodox medicine. The way such an argument is generally advanced, however, more often than not tends to discard orthodox medicine as a viable therapy for other ailments. This is an error of attack in propaganda known as 'poisoning the well', where a speaker is so committed to a position that he/she explains away absolutely everything that others offer in opposition.

The way the advertisers stir up nostalgic feelings in the audience is also noteworthy. Consider the following:
Since the dawn of time, man has understood which leaves, fruits, seeds and roots of plants around him were beneficial for the maintenance of health and effective for the remedy of different ailments that he suffers from.

(The News, April 11, 2005: 15)

The trick of advertising here is referred to as argumentum ad vercundium. It is an appeal to tradition and authority in support of some contention. According Taflinger (1996b), the use of the fallacy is suggestive of the popular saying: "As it was in the beginning, is now and ever shall be". This is an appeal to the earliest beginnings to counter Eurocentric claims, for example, that Africa had no past, no (healing) culture and therefore no civilization before the introduction of western (healing) culture.

The place of evidence, that is, information used as logical proof by a persuasive speaker also deserves careful analysis in the discourse of advertising herbal products. According to O'Hairr (1975: 594), "Evidence in whatever form it takes, increases the persuasiveness of a message [...] highly credible evidence sources are more persuasive than less credible sources." For our present purposes, we shall focus on examples, statistics and testimony as forms of evidence.

The use of examples creates vivid images in the minds of receivers. Lucas (1992: 122) argues:
Research has shown that vivid, concrete examples have more impact on listeners' beliefs and actions than any other kind of supporting material. Without examples, ideas seem vague, impersonal, and lifeless. With examples, ideas become specific, personal and lively.

One kind of example recurrent in the discourse is extended example which involves the use of anecdotes. Recounting an anecdote falls under the rhetorical strategy known as 'narration'. Let us consider the following extract:
There have been bizarre cases in our clinics recently which I know no foreign products would have been able to handle. Take for instance a woman who suffered what was diagnosed in the hospital as kidney problem. After a protracted battle using synthetic drugs and those foreign stuffs, the lady was confined to hospital bed [...] We gave her some herbal preparations which made her belch and this cleared all the impurities.

(Tell, March 7, 2005: 17)

By presenting this anecdote, the advertiser is able to keep the hope of the audience alive, giving the impression that if others got healed by using the advertiser's herbal products, the audience could also experience the same. Using such an appealing event to boost the morale of the audience, as we pointed out earlier, is a case of the use of 'euphoria'. But we should quickly note that the advertiser may just be saying what would interest the audience in order to sway them. This is because examples are either factual or hypothetical. They are factual if the incidents they refer to really happened, while they are hypothetical when they describe an imaginary situation. In view of the fact that the goals of seeking popularity with the people and achieving specific commercial objectives cannot be completely ruled out in the external world of reality, the anecdote the advertiser uses here could be hypothetical just to defraud the audience. As a matter of fact, one must not gloss over the use of the rhetorical strategy 'absolute certainty' in the expression "[...] which I know no foreign products would have been able to handle" which gives the writer's statement an indisputable air. We have to emphasize the fact that knowledge is relative; what the advertiser claims to know here within the limits of his knowledge and exposure may not be tenable when subjected to further tests.

The advertisers of herbal products also employ testimony. According to Lucas (1992: 135–136), we could have expert testimony, that is, testimonies from people who are acknowledged authorities in their fields and peer testimony, that is, opinions of ordinary citizens who have first-hand experience on the subject. We shall consider an excerpt here on expert testimony.
Tens of thousand who have suffered acute obesity, diabetes, rheumatism, high fever, anemia, fibroid, skin disorders, peculiar ailments, etc., have always attested to the efficacy of these drugs which have been certified by NAFDAC.

(Tell, September 5, 2005: 14)

In this testimony, two salient issues are brought to the fore. First, the reference to the numerical strength "tens of thousands" invokes the propaganda technique of 'bandwagon' which is an attempt to persuade the target audience to join in and take the course of action that everyone else is taking. Calling on the audience to join the crowd reinforces people's natural desire to be on the winning side. Thus, crave for herbal therapy is presented here as an irresistible mass movement and it is in the best interest of the audience to join. The use of statistics in the discourse creates a definite rhetorical effect. No doubt, we live in an age of statistics but we must be wary of its use for there is usually more to statistics than meets the eye. Darrel Huff cited by Lucas (1992: 128) argues that although numbers do not lie, they can easily be manipulated and distorted. In the extract above, the advertiser's reference to "tens of thousands" who have attested to the efficacy of the advertiser's products sounds rather dubious moreso that there is no way the audience could test or confirm the figure.

Other examples of the ab/use of statistics in the discourse include "Our guarantee is 100%", "100% herbal ingredients", and "The medicine will increase sperm count from zero to 85 million". By projecting such staggering figures, the advertiser is trying to give an air of scientific precision that the audience cannot judge for themselves. We have to point out here that the advertisers of herbal medicine seem to borrow the style characteristic of orthodox medical discourse that thrives on scientific proofs based on tests and studies that are statistically driven. But where it can be said in orthodox medical discourse that adequate surveys and tests must have been carried out not just by an individual but in most cases a team of researchers before arriving at statistical data, this cannot be said of herbal medical practice which thrives mainly on idiosyncratic strides, the processes of which are not readily amenable to empirical verification. However, the technique of using statistics here can be linked to the concept of 'intertextuality' which reminds us that each text exists in relation to others. According to Allen (2005: 1):
The fundamental concept of intertextuality is that no text, much as it might like to appear so is original and unique-in-itself; rather it is a tissue of inevitable and to an extent unwitting, references to and quotations from other texts. These in turn condition its meaning; the text is an intervention in a cultural system.

The second interesting issue that their drugs have been certified by the National Agency for Food and Drugs Administration and Control (NAFDAC) needs to be critically examined. It is interesting that most of the advertisers of herbal products claim that their products have been certified by NAFDAC and, therefore, carry NAFDAC REGISTRATION NUMBER – a semiotic label that has become a stereotype in Nigeria's food(drinks) and drugs industries. The word 'stereotype', according to Quasthoff (1978: 3), could mean "something like 'constantly repeated', 'meaningless' with respect to verbal clichŽs". This is the sense in which we treat the constant NAFDAC REGISTRATION NUMBER in the present situation and in wider national discourse. In this situation, we do not intend to discredit NAFDAC whose achievements under the leadership of Professor Dora Akunyili have been unprecedented:
The achievements of the agency under the dynamic leadership of Akunyili are outstanding and encouraging. NAFDAC is now a household name, as her aggressive crusade against fake, counterfeit drugs and unwholesome processed foods has reached the grassroots. Consumers now scrutinize regulated products for the manufactured, expiry dates and NAFDAC registration numbers.

(The News, August 22, 2005: 9)

It is against this backdrop that manufacturers (not only of herbal products) in Nigeria now attempt to legitimize their products by attaching the ritualistic NAFDAC REGISTRATION NUMBER as the seal of marketability and attendant consumption to them. Although NAFDAC has a directory of certified products, desperate manufacturers could still fake the NAFDAC REGISTRATION NUMBER to deceive the consumers.

Another kind of testimony employed in the discourse is the celebrity testimonial. This is in tandem with the 'Endorsement or Testimonial claim'. According to Schrank, "a celebrity or authority appears in an ad to lend his or her stellar qualities to the product". For example, popular musicians, actors and actresses are used to advertise herbal products. Obesere, a popular Fuji musician in Nigeria, endorsed 'Energy 2000' prepared by Yemkem Herbal Home. What is interesting about the use of this claim is that the celebrities usually claim to use the product but we know very often they do not. The reality of the situation is pictured by Lucas (1992: 139) that the celebrities must have been paid "large sums of money to be photographed with the product in hopes that their popularity will rub off on the product".

The perceived status of the celebrities and the kind of environments/settings where they are photographed serve some rhetorical functions. In the advertisements, especially on television, men dress corporately in shirt, tie and suit while women dress corporately as well in skirt(suit) and blouse/shirt or in trendy native wears. To complement all of these, the setting or environment where they interact is usually a banking hall or an office space. The dress code and the setting are semiotically deployed to give the impression that herbal products are not consumed by only rural dwellers; the elite in the cities also use them.

On a final note, the deployment of temporal deictic forms in the discourse is rhetorically compelling. Consider the following:
From now on no doctor can sentence you to death.
Time past, it was unending confinement to hospital bed [...] But now times have changed.
[...] Get ready for a unique experience of the power of African
medicine as never before.
It's a new dawn in African medicine.

(underlining mine)

All of these underlined expressions and others such as "before", "now", and "over the ages", are used to capture the transitional phases in the development of African medicine, on the one hand, and the supposed displacement of orthodox medicine by herbal therapy, on the other hand. Time, therefore, becomes an important variable in the discourse. In some cases, advertisers seem to abuse such temporal deictic forms while attempting to underscore the efficacy of their products. The following examples will suffice:
Lose 10kg in five days.
Treatment for diabetes under one month.
Penis enlargement within one month.
We have herbal supplement that reduces blood sugar in two weeks.
Gonorrhea: This disease is cured within 24 hours with our herbal solution.
Increase in sperm count could be attained within 72 hours after proper medication has been administered.

Given the amazingly short time frame within which the advertisers promise to heal diseases and the attendant tone of finality even when the state of the patient has not been determined, we are compelled to call attention to the exaggerative power of the advertisers in the discourse. Thus, we comment on the role of hyperbole as a pragmatic strategy in advertising herbal products. Leech (1983: 145) explains that hyperbole 'refers to a case where the speaker's description is stronger than is warranted by the state of AFFAIRS DESCRIBED [...]' To Swartz (1976: 101) "[...] hyperbole provides a means of focusing on specific aspects of reality (whether social or physical) in such a way as to bring about awareness of values and norms associated with those aspects in an emotionally charged way."

The use of hyperbole would normally violate the maxim of 'quantity' in Grice's cooperative principle. According to Grice (1999), the category of Quantity relates to the quantity of information to be provided and under it fall the following maxims:
1. Make your contribution as informative as is required (for the current purposes of the exchange).
2. Do not make your contribution more informative than is required.
(Grice 1999: 78)

As seen in the way herbal medical practitioners advertise their products, they flout the maxim of quantity by sounding rather hyperbolic in their claims. This lends credence to Komolafe's (1998: 71) view: "In a state of professional anxiety and insecurity, the Traditional Healers ignorantly and at times intentionally make sensational or headline news with wrong unproven claims of curative ability." This is why critics of herbal medicine have descended heavily on the practitioners that they sometimes claim feats beyond their capabilities, a disposition that can make the unwary patient complacent until more damage is done. Giving herbal practitioners a hard knock, the critics see some of them as charlatans who do not have knowledge of effective treatments they claim they can cure (Danesi 1998).

Concluding Comments

We have hitherto examined the persuasive techniques employed by medical practitioners in advertising their products. The discussion focuses on the deployment of propaganda techniques such as bandwagon, testimonials, assertion, euphoria, and narration, among others. Besides, the discussion touched on certain rhetorical strategies that make the characters worthy of confidence, and also appeal to the emotions of the audience. Generally, the discussion reveals that the discourse dwells essentially on the four types of arguments or propositions we highlighted at the outset. In the main, the advertisements reflect a general description of a state of affairs in which health matters have truth value (proposition of fact) though ridden with controversial issues. In doing so, herbal healing and orthodox medical practice are evaluated (proposition of value) and the advertisers consider the so-called inadequacies of orthodox medical practice a problem requiring solution (concern about a problem). This informs the projection of herbal therapy as alternative therapy to orthodox medicine (proposition of policy). In advancing these arguments, however, the advertisers have largely engaged in marketing hype. It is interesting that herbal medical practitioners never present their products as those that can control, manage or suppress (symptoms of) diseases. It is permanent cure all the way! Besides, their products are never presented to the consumers as having any side effects. There is, therefore, the overriding effect of the rhetorical strategy of 'absolute certainty' that pervades the discourse. On the contrary, the advertisers embark on the spirited effort at challenging the efficacy of western medicine, thereby creating discontentment with the conventional products that the audience already knows
          Comment on Online discussion: Addressing gender stereotypes in the classroom: how to achieve a conducive environment for adolescent girls’ learning by Wikigender        
We are posting this comment on behalf of Jennifer Kotta from the UNESCO Office in Dar es Salaam, Tanzania Addressing gender stereotypes in the classroom 1. How is the learning environment influencing adolescent girls ‘education outcomes? In Tanzania, despite the effort of the government to ensure equal access and retention of both boys and girls in schools, participation of girls in education still face challenges related to unconducive school environment that negatively impact their performance especially at secondary school level. Some schools especially in rural areas do not have adequate facilities conducive for girls’ participation in schools. Such facilities include insufficient toilets, lack of water, electricity and basic health services (serviettes and pain killers) to support adolescent girls. Some of them miss school during their menstruation period which affect negatively their educational outcomes. Most of secondary schools do not have boarding facilities, adolescent girls are obliged to rent rooms in villages located around the schools and most of the times the schools do not have in place a support system to ensure those girls are safe and concentrate on their studies. Some of the adolescent girls living in those conditions are victims of teenage pregnancies and rarely finish secondary education. 2. What are some of the recent trends in the development of teaching materials (including textbook content): • In order to enhance learning, the recent trends is the introduction of blended learning modalities in Teacher Training colleges which include the use of learning management systems and library systems. • Pre-service teachers for science and mathematics have been introduced to ICT integration in teaching and learning therefore adolescent girls in Tanzania will soon be introduced to digital learning modalities. • UNESCO Tanzania Office has installed a digital school to enhance performance of adolescent girls from hard to reach and disadvantaged pastoralist communities in Ngorongoro. A learning management system called ELIMIKA (meaning Learn) has be installed at the digital school. It has approved curriculum for students and content to enhance teachers’ pedagogical skills. Four secondary schools have been connected to the digital schools. 3. What are some of the policies, compains and initiatives that successfully helped to counter gender stereotypes in school setting? UNESCO Dar es Salaam office has undertaken the following actions at school level: - Creation of girls’ clubs/safe spaces and peer mentoring. A safe space is a place in the school environment and a group of students (80% girls and 20% boys) where members know they are safe from physical harm or harassment, and where they feel free to express their honest opinions, share their problems and pressures, and support and encourage one another to pursue their educational goals. UNESCO developed training material for safe space creation and sustainability in schools:  Guide for facilitators  Guide for students  Hand book and resource kit. The safe spaces serve as launching pad for any interventions planned for girls’ empowerment. To enhance girls’ empowerment and confidence in schools, UNESCO collaborates with the Forum for African Women Educationalist – FAWE Tanzania Chapter in introducing the TUSEME meaning “Let speak out” girls’ empowerment package. - Support to teachers and education management at local administration level in providing them adequate knowledge and skills to create conducive learning environment for both girls and girls at school. A toolkit for teachers to apply inclusive and gender- responsive approaches in the schools have been developed by adapting the UNESCO Inclusive Learning Friendly Environment Toolkit (ILFE). The main objective of the toolkit is to provide practitioners with adequate knowledge on Inclusive Education as well as user-friendly materials that can be used by teachers who find themselves working in ever more diverse classrooms. It also offers a holistic, practical perspective on how schools and classrooms can become more inclusive and learning-friendly for both girls and boys. In addition to the ILFE training for teachers, UNESCO in collaboration with the Forum for African Women Educationalists – FAWE Tanzania Chapter organise training of teachers on Gender Responsive Pedagogy (GRP). The attitude of teachers and pedagogical skills can influence negatively the educational outcome of adolescent girls. The objective of that intervention is to help teachers improve their teaching methods in order to improve participation, retention and performance of girls at school. 4. How can we advocate for a stronger measurement framework and solidify indicators on gender inequality in education, so that we can know where progress is being made and where challenges remain? In order to solidify indicators on gender inequality in education the following suggestions can be advocated to decision makers: • Advocate for SDG4 indicators for gender to be integrated in the mainstream education monitoring framework. • Assessment of the available School Management Information System that provides real-time data on the status of the schools including gender issues so that the system can be mainstreamed to inform better decision makers and to help address problems in a timely manner. • Continue to introduce programmes that encourage girls to take maths and science subjects for future STEM female experts.
          More on the Denominational Health Plan        
Yes, I know there's an alternate budget proposal on the table!  I'm working that issue and will publish a post as soon as I finish my analysis.  In the meantime, here's this!

Over at Seven Whole Days, Scott Gunn has proposed a principle on political resolutions at General Convention:

Let us tell the world what we are going to do about political problems, rather than telling the world what they should do about political problems.

Well, General Convention has certainly told the US government what IT should do about the problem of health care coverage in the United States.  In 2009 alone:

2009-C071 called on all parts of the church to advocate for universal basic health care for all;

2009-D048 called for universal health care coverage and a single-payer heath care plan;

2009-D088 called for national universal health care reform.

Now it’s time for us to put our money where our mouth is.  That’s what the US government should do; well, what should we do?  It’s easy enough to demand that someone else do something about people who lack health insurance; can we stand behind our convictions when it is going to cost usmoney?

That’s what we decided to do in 2009.  Resolution A177 established the Denominational Health Plan, to be administered by the Medical Trust of the Church Pension Group.  The DHP has two basic goals: 

  • Containing healthcare costs for the church in light of rapidly increasing healthcare costs nationwide; and
  • Equal access to healthcare coverage for clergy and lay employees.

Worthy goals – but the DHP has run into some controversy.  Mostly because we have suddenly discovered that covering additional people will cost additional money!  Surprise, surprise!  Justice requires some sacrifices!

Let’s make a couple of points absolutely clear:

  • It is absolutely essential for the economics of the plan that everyone be required to participate, because of the concept of “adverse selection,” which I explained in detail here.  Basically, this means that without a mandate, healthier and cheaper employees and groups will be motivated to buy their insurance elsewhere, leaving CPG to cover only older, sicker employees, raising the cost of CPG insurance for everyone. 
  • The mandate has not gone into effect yet!  It does not become effective until January 2013!  That means that we have no basis yet on which to judge the effectiveness of the Denominational Health Plan. Don’t judge the DHP as ineffective when we haven’t even seen it at work yet!
  • Some folks have complained that since adopting CPG insurance, their health insurance premiums have continued to increase, and cited this as evidence that the DHP isn’t doing its job.  Folks – health costs across the country have continued to increase, by about 9% a year.  A CPG representative tells me that CPG insurance has increased by an average of about 5% a year.  This lower percentage increase is direct savings to us ($37 million so far, according to CPG), attributable to the fact that numerous dioceses have already joined the plan.  Don’t blame CPG that health costs in the U.S.  continue to rise!
  • The fact is that the Denominational Health Plan directly pits the interests of clergy employees against those of lay employees.  I believe that clergy need to be very, very careful about voting their own interests in opposition to lay interests.  Lay people are vastly underrepresented in the councils of our church, because there are far more lay people than clergy people, but we have the same number of deputies to General Convention.  If anything, clergy need to bend over backwards to protect the interests of lay people, without whom we wouldn’t have much of a church.  We clergy should not be using our disproportionate power to trample on lay interests.  

Now, on to some more specifics.  The controversies over the DHP fall into three categories:

     1.  Requiring clergy and lay benefits to be equal means either you have to reduce clergy benefits, or you have to offer lay people the same Cadillac benefits the clergy have been getting all these years.  And make no mistake, many clergy people receive true Cadillac plans.  Where most secular employers these days offer high-deductible, low-cost plans, and require employees to pay part of the premiums, clergy have gotten used to expecting low-deductible, benefit-rich plans, fully paid by the church, including full family coverage.  Such a plan in my diocese (Arizona) could easily cost $25,000 a year. 

This is a way, way better plan than the average American worker can expect to receive.  According to a study by the Kaiser Family Foundation, the average American receives a plan worth $15,073 per year, and personally pays 27.3% of the premiums, or $4,129.  (Click Here for the report; click on “Report” and see Figure 16 on page 25.)

So, in a limited-resource world, do we bring the clergy down from a Cadillac to a Chevy in order to provide a Chevy to lay employees too?  I argued here that dioceses actually have the power to create transition rules to phase the new rules in over time, not taking away anyone’s Cadillac, but providing Chevys to all new employees.  I think this is a reasonable result.

Honestly, I think the gospel call to provide health insurance to our full-time lay employees who don’t have other coverage (such as spousal coverage, etc.) really couldn’t be clearer.  I am stunned that anyone who follows the gospel would think otherwise.  See Scott Gunn's post here for a few cogent arguments about this.

     2.  Some people believe that CPG insurance costs more than insurance under other plans.  This may well be true because of the nature of The Episcopal Church’s covered group – mostly clergy, who are older (and therefore less healthy and more expensive) than the average American.  Requiring all employees to be covered may well bring down the average cost for everyone, because as it is, the expensive older employees are the only ones who have an incentive to join the CPG plan.  That's adverse selection for you!  If you don't know what I'm talking about, click here for info.  

Again, the DHP is not fully implemented yet; until it becomes mandatory on Jan. 2013, we will have no way of judging how powerful the effect of the mandate will be.  It is not fair to judge the DHP as inadequate when it hasn’t even gone into effect yet. 

     3.  Differences in price among various groups in the church (for instance, geographic groups).  According to a CPG representative, before the DHP was implemented, CPG health insurance had 14 different pricing “bands,” or price structures, based on factors like geography, demographic characteristics of the group, etc.  They have already reduced this to 10 bands, and will go to 7 bands when the mandate is implemented next year.  This means that pricing differences are being narrowed already, at CPG’s initiative.  

Please note that it IS possible for CPG to institute one standard price that applies churchwide.  However, this would mean that lower-cost groups would be subsidizing higher-cost groups.  It would mean that dioceses in lower-cost areas like Phoenix and Seattle would be paying extra to account for the higher cost of medical care in New York City and Miami.  We as a church should decide whether we are willing to do this. 

The economic risk of letting low-cost groups subsidize high-cost groups is that CPG insurance would be noticeably more expensive than private insurance in low-cost areas, providing an incentive for those cheaper dioceses to drop out of the plan, raising the average cost of insurance for everyone left behind.  Adverse selection at work, again!  Participation in the plan mustbe mandatory for it to work. 

So – back to the beginning. Should we spend another convention telling the US government what it should do about health care reform? Or should we act on our own to do justice for our lay employees?

As Scott Gunn says, let’s stop telling the world what they should do, and start telling the world what WE are going to do.  Let’s make sure our lay employees are covered.  It’s responsible, it’s fair, and it’s our gospel call to love our neighbors as we love ourselves.

          Health Tips for Delivery Industry Workers        
Driving can be very hard work. While that statement seems to fly in the face of common sense, the all too mundane activity of sitting and steering involves a high degree of mental and physical exertion, when engaged in professionally. Long routes require couriers to combat bleary eyes, stiff muscles, lack of sleep and dangerous lapses in concentration to make sure they reach their destinations safely.

Indeed, the chronic stresses of long periods in a vehicle can result in long-term and sometimes serious health concerns. Hence basic health precautions need to be heeded to assure a long and prosperous career.

A balanced diet

Most people do not put couriers in the same category as athletes, or even with those who work in obviously strenuous professions, such as construction workers or landscape gardeners. But if you make your living by taking on owner driver jobs, you will push your body to its limits through the constant demands on concentration, movement and stationary focus required when driving all day. Hence it is vital you prepare your body to meet these demands. You will need to not only ingest adequate amounts of energy, protein, vitamins and water, but you will also have to avoid the various mental and physical vagaries caused by too much sugar, carbohydrates, and alcohol.


While it is indeed a burden on your body to drive a car or steer a bike for hours on end, the burden is largely caused by certain muscles being overworked, while others remain far too stationary. This is why those who take on owner driver jobs should exercise in a particular way that prepares their muscles. They need to be able to endure the long hours on the road by stretching and engaging in the appropriate resistance and cardio training, so as to avoid back problems, muscle spasms, headaches and long-term injuries.

A steady routine

One of the greatest difficulties many couriers face when they rely on owner driver jobs is bad scheduling. They often need to be at the beck and call of their clients' demands. Sometimes, this means working at odd and erratic hours. The consequences of disrupted sleep and meals can play havoc on the long-term health of couriers. Therefore any stability that you can add to your routine will work wonders at mitigating the health effects of these disjointed travel schedules.

Regular health checks

If you make a living with owner driver jobs, chances are, that like many small business managers, you will go through fluctuations in the state of your assets and funds. But when times are lean financially you should not eschew regular health checks. Visiting a health professional to check your spine, eyesight, concentration, hand-eye coordination and general well-being is an investment in your long-term working future and insurance against potential costly chronic problems. These visits can also help you find ways to make your daily work more enjoyable and fruitful by obviating niggling aches and pains and improving a sense of satisfaction.

Norman Dulwich is a correspondent for Courier Exchange, the world's largest neutral trading hub for same day owner driver jobs in the express freight exchange industry. Over 2,500 transport exchange businesses are networked together through their website, trading jobs and capacity in a safe 'wholesale' environment.

          Comment on Work/Life Balance Is the Wrong Paradigm by Robin Mallery        
Catherine, Timely and thoughtful post here; you blend reality and kindness with pragmatism. Well done. I suggest this self-care consideration to compliment the mindset that you have offered: when we have a foundation of basic health-sustaining choices included in our busy day, the allocation of our time and energy will flow more smoothly. Our energy will be higher, our mood will be more stable, and our thoughts and decisions will be more clear when we choose to allocate adequate sleep of good quality, small meals that provide nourishment and satisfaction, physical activity to enhance glucose metabolism, and a few mindful moments throughout the day to dissipate adrenaline/catecholamine hormones. In terms of our ability to go with the ebb and flow of business and personal considerations, taking care of our own basic physical and emotional needs will make all the difference in our ability to do so kindly and effectively.
          RN, Registered Nurse (12) - Medical/Surgical/Telemetry (FT Nights) - (Long Beach, California, United States)        
At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. MemorialCare stands for excellence in healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary: Under general supervision, the Registered Nurse provides professional nursing care to patients in accordance with individual needs, physician orders, hospital policy and standards of nursing practice. Those functions, including basic health care, which help people cope with difficulties in daily living which are associated with their actual or potential health or illness problems, or treatment, which require a substantial amount of scientific knowledge or technical skill. Work Experience: Minimum 1 year acute care RN experience within the previous year preferred. Education | Licensure | Certifications: Current state of California RN License. Current BLS and ACLS certification. BSN preferred.
          RN, Registered Nurse (12) - ICU (FT Nights) - (Long Beach, California, United States)        
At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. MemorialCare stands for excellence in healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary: Under general supervision, the Registered Nurse provides professional, individualized nursing care to patients through observation, assessment and intervention in ICU procedures in compliance with hospital policy, physician orders, and standards of nursing practice. Those functions, including basic health care, which help people cope with difficulties in daily living which are associated with their actual or potential health or illness problems, or treatment, which require a substantial amount of scientific knowledge or technical skill. Work Experience: Minimum 1 year critical care experience within the previous year preferred. Education | Licensure | Certifications: Current State of California RN License. Current BLS, ACLS certification. BSN preferred. CCRN preferred.
          RN, Registered Nurse (12) - Medical/Surgical/Telemetry (FT Nights) - (Long Beach, California, United States)        
At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. MemorialCare stands for excellence in healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary: Under general supervision, the Registered Nurse provides professional nursing care to patients in accordance with individual needs, physician orders, hospital policy and standards of nursing practice. Those functions, including basic health care, which help people cope with difficulties in daily living which are associated with their actual or potential health or illness problems, or treatment, which require a substantial amount of scientific knowledge or technical skill. Work Experience: Minimum 1 year acute care RN experience within the previous year preferred. Education | Licensure | Certifications: Current state of California RN License. Current BLS and ACLS certification. BSN preferred.
          RN, Registered Nurse (12) - Medical/Surgical/Telemetry (FT Nights) - (Long Beach, California, United States)        
At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. MemorialCare stands for excellence in healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary: Under general supervision, the Registered Nurse provides professional nursing care to patients in accordance with individual needs, physician orders, hospital policy and standards of nursing practice. Those functions, including basic health care, which help people cope with difficulties in daily living which are associated with their actual or potential health or illness problems, or treatment, which require a substantial amount of scientific knowledge or technical skill. Work Experience: Minimum 1 year acute care RN experience within the previous year preferred. Education | Licensure | Certifications: Current state of California RN License. Current BLS and ACLS certification. BSN preferred.
          RN, Registered Nurse (12) - ICU (FT Nights) - (Long Beach, California, United States)        
At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. MemorialCare stands for excellence in healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary: Under general supervision, the Registered Nurse provides professional, individualized nursing care to patients through observation, assessment and intervention in ICU procedures in compliance with hospital policy, physician orders, and standards of nursing practice. Those functions, including basic health care, which help people cope with difficulties in daily living which are associated with their actual or potential health or illness problems, or treatment, which require a substantial amount of scientific knowledge or technical skill. Work Experience: Minimum 1 year critical care experience within the previous year preferred. Education | Licensure | Certifications: Current State of California RN License. Current BLS, ACLS certification. BSN preferred. CCRN preferred.
          RN, Registered Nurse (12) - Medical/Surgical/Telemetry (FT Nights) - (Long Beach, California, United States)        
At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. MemorialCare stands for excellence in healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary: Under general supervision, the Registered Nurse provides professional nursing care to patients in accordance with individual needs, physician orders, hospital policy and standards of nursing practice. Those functions, including basic health care, which help people cope with difficulties in daily living which are associated with their actual or potential health or illness problems, or treatment, which require a substantial amount of scientific knowledge or technical skill. Work Experience: Minimum 1 year acute care RN experience within the previous year preferred. Education | Licensure | Certifications: Current state of California RN License. Current BLS and ACLS certification. BSN preferred.
          RN, Registered Nurse (12) - Medical/Surgical/Telemetry (FT Nights) - (Long Beach, California, United States)        
At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. MemorialCare stands for excellence in healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary: Under general supervision, the Registered Nurse provides professional nursing care to patients in accordance with individual needs, physician orders, hospital policy and standards of nursing practice. Those functions, including basic health care, which help people cope with difficulties in daily living which are associated with their actual or potential health or illness problems, or treatment, which require a substantial amount of scientific knowledge or technical skill. Work Experience: Minimum 1 year acute care RN experience within the previous year preferred. Education | Licensure | Certifications: Current state of California RN License. Current BLS and ACLS certification. BSN preferred.
          RN, Registered Nurse (12) - BHU (FT Days) - (Long Beach, California, United States)        
At Memorial Care Health Systems, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary: Under general supervision, the RN provides professional nursing care to patients in accordance with individual needs, physician orders, hospital policy and standards of nursing practice. Those functions, including basic health care, which help people cope with difficulties in daily living which are associated with their actual or potential health illness. Must have critical thinking skills, problem solving ability and the ability to communicate and make safe judgment calls in stressful situations. Must be able to must be able to multi task and communicate in a professional way. Must have basic computer skills. Qualifications: Must have at least 1 year inpatient acute mental health experience is preferred, willing to train new grad with interest in mental health. Must have current California RN license. Current BLS/CPI certification. At Memorial Care Health Systems, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary: Under general supervision, the RN provides professional nursing care to patients in accordance with individual needs, physician orders, hospital policy and standards of nursing practice. Those functions, including basic health care, which help people cope with difficulties in daily living which are associated with their actual or potential health illness. Must have critical thinking skills, problem solving ability and the ability to communicate and make safe judgment calls in stressful situations. Must be able to must be able to multi task and communicate in a professional way. Must have basic computer skills. Qualifications: Must have at least 1 year inpatient acute mental health experience is preferred, willing to train new grad with interest in mental health. Must have current California RN license. Current BLS/CPI certification.
          RN, Registered Nurse (12) - Medical/Surgical/Telemetry (PD Nights) - (Long Beach, California, United States)        
At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. MemorialCare stands for excellence in healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary: Under general supervision, the Registered Nurse provides professional nursing care to patients in accordance with individual needs, physician orders, hospital policy and standards of nursing practice. Those functions, including basic health care, which help people cope with difficulties in daily living which are associated with their actual or potential health or illness problems, or treatment, which require a substantial amount of scientific knowledge or technical skill. Work Experience: Minimum 1 year acute care RN experience within the previous year preferred. Education | Licensure | Certifications: Current state of California RN License. Current BLS and ACLS certification. BSN preferred.
WellmanLive Longer by Controlling Inflammation

By Graham Simpson

$29.10   25 May 2010   Paperback   Basic Health Publications

EarthingThe Most Important Health Discovery Ever?

By Clinton Ober, Stephen T. Sinatra, Martin Zucker

$29.10   25 Apr 2010   Paperback   Basic Health Publications

          Health Benefits Derived from Sweet Orange        
Health Benefits Derived from Sweet OrangeBy Frank Murray

$9.95   25 Sep 2007   Paperback   Basic Health Publications

Discusses the eight most common vein complications: varicose veins, hemorrhoids, diabetes, leg ulcers, ankle swelling, capillary fragility, leg cramps and phlebitis. A safe, natural, and effective solution for these conditions is in the rind of sweet oranges, an anti-inflammatory bioflavonoid called diosmin. In supplement form diosmin promotes strong veins, healthy legs, and sound circulation. Sources and brand names for diosmin supplements are included.

          Rs 10290 crore boost for health hides funding cuts for key programmes        
Despite a Rs 10,290-crore increase in health funding for 2017-18, an investigation of the central government's health budget reveals that most of this money is not being spent on India's health priorities, which, instead, now face funding cuts.

Elimination of tropical diseases (kala azar, filariasis and leprosy) over the next two years; elimination of a vaccine-preventable disease (measles) by 2020. Elimination of tuberculosis (TB) by 2025; and "significant reduction" of infant and maternal mortality by 2020: These were some key proclamations related to health made by Union Finance Minister Arun Jaitley during his February 1, 2017, budget speech for 2017-18.

Given that India has an infant mortality rate (IMR) of 37 per 1,000 live births–or higher than the average for 154 middle- and low-income countries–the world's highest TB burden, with 27% of the world's new cases, and accounts for 58% of new leprosy cases detected globally, Jaitley appeared to address some of India's most significant public-health concerns. Adequate funding could lead to significant improvement in India's health systems and health status.

But Jaitley's budget indicates inadequate allocations or funding cuts to his declared priorities. Most of the Rs 10,290-crore increase will be spent on issues regarded as low priority: New medical colleges, new premier medical institutions and converting health sub-centres into "health and wellness centres"–but with no more than Rs 60,000 per centre annually.

The question then is, where has this additional money gone? To open new medical colleges, new premier medical institutions–while older ones languish–and converting 150,000 health sub-centres into "health and wellness" centres but without adequate funding.

Measles: Ambitious targets and a Rs 1,000-crore funding cut

To eliminate measles, India will need to invest in stronger immunisation systems and social mobilisation. Most countries that have eliminated measles have used some form of a campaign approach, as India has by starting the first phase of a measles-rubella vaccine campaign to immunise 35 million children in 2017 and 410 million children over the next two years, as this World Health Organization statement pointed out.

Has money been set aside to achieve these targets? It appears not.

The union health budget includes a separate head, the National Rural Health Mission (NRHM), to fund state rural healthcare. Within the NRHM budget is a sub head called the "Reproductive and Child Health (RCH) flexi-pool", which sets aside funds for immunisation, including funding of the polio-eradication campaign. To improve healthcare in urban areas (where measles remains a significant problem due to high population densities), the central budget sets aside money under the head National Urban Health Mission (NUHM).

To fund the measles campaign and eliminate measles, funding under RCH flexipool (for rural areas) and under NUHM (for urban areas) should have been higher than previous years.

Instead, funding for the RCH flexi-pool has been cut 23%, by more than Rs 1,000 crore, from Rs 5,932 in 2016-17 to Rs 4,566 in 2017-18.

Similarly, funding for the National Health Mission, which aims to provide universal access to affordable and quality healthcare and funds both NRHM and NUHM, has been reduced by Rs 197 crore over a year.

TB: As deaths double, a Rs 13-crore cut in funding

India had double the number of estimated TB deaths in 2015–480,000, up from 220,000 deaths in 2014–because previous estimates were too low, as IndiaSpend reported in October 2016..

India has 27% of the world's new TB cases–one of the biggest infectious disease killers in India. The country had 2.8 million new TB cases in 2015, up from 2.2 million cases in 2014, according to the World Health Organization's Global Tuberculosis Report 2016.

In such times, moving the goal post from control to elimination makes sense. In January 2017, the Supreme Court also directed the government of India to move from alternate-day medication to a more effective daily regime. But this would be require a larger budget.

As we said, the union budget's NHRM head provides for healthcare in rural India. Within this budget head is a sub-head called "Flexible Pool for Communicable diseases", which includes funding for the Revised National Tuberculosis Program.

Now, funding appears to have increased by Rs 87 crore over a year to 2017-18, but the revised budget estimates–drawn up after the budget is presented–reveals a drop of Rs 13 crore over 2016-17.

Adjusting for purchasing power parity, the funds available for TB control would be even lower, which means there are no new investments at a time when the TB programme needs to be expanded.

Maternity benefit only for first borns; funding short by Rs 11,812 crore

In the 2017-18 budget, funding for Indira Gandhi Matritva Sahyog Yojna (Maternal Benefit Scheme) has risen 226%, from Rs 634 crore ($94.6 million) in 2016-17 to Rs 2,700 crore ($298 million) in 2017-18, but this allocation, as IndiaSpend reported on February 22, 2017, isn't enough to cover all expectant mothers.

The government had estimated that the the annual requirement for this maternity benefit scheme–which provides iron and folic-acid supplements to pregnant women to prevent maternal anaemia, sepsis, low birth weight, and preterm birth–would be Rs 14,512 crore ($2.1 billion), according the report of the Standing Committee on Food, Consumer Affairs and Public Distribution (2012-13).

"At the rate of Rs 1,000 per month for six months, the scheme expenditure towards maternity benefits to 2.25 crore pregnant and lactating women works out to Rs 14,512 crore per annum," said the report, quoted in the Indian Express on February 18, 2017.

So, the ministry plans to provide maternity benefits only to first-borns, leaving other children vulnerable.

Of Indian infants who died within 29 days of being born between 2010 and 2013, 48% were underweight or were premature. India has more than 3.5 million preterm births every year, more than any other country, IndiaSpend reported in November 2016.

So where has the additional Rs 10,290 crore gone?

India's health budget, as we said, rose Rs 10,290 crore in 2017-18 compared to the previous year. While this appears higher than ever, it is inadequate to bring India–which currently spends less than 1.5% of gross domestic product (GDP) on health–close to a minimum desirable health spend: 2% of GDP. As we have seen, this additional money does not seem to have gone to the government's priorities: Reducing infant mortality or control of TB and other communicable diseases.

Source: Union Budget, 2017-18; * Setting up of two more AIIMS; ** Revised estimates for 2016-17; *** Universal health insurance scheme

Rs 2,855-crore increase for new medical colleges in districts

A major increase in budgetary allocation has been towards more medical colleges at district hospitals, an increase of Rs 2,855 crores, accounting for about 27% of the Rs 10,290-crore rise in health funding.

India does need more medical graduates, but increasing medical colleges will not be easy, considering that even premier institutes, such as branches of the All India Institute of Medical Sciences (AIIMS), set up by ministry of health and family welfare, in state capitals are struggling. For instance, five years after the first batch was admitted, AIIMS Bhopal does not yet have a blood bank and does not conduct surgeries, and important faculty positions are vacant, The Hindu reported in January 2017.

Rs 1,525-crore increase for new AIIMS, while older ones struggle

That bring us to the other significant funding increase: Rs 1,525 crore more over 2016-17 for Pradhan Mantri Swasthya Suraksha Yojna (the Prime Minister's Health Protection Scheme), which is not the same as the more well-known Rashtriya Swasthya Suraksha Yojna (National Health Protection Scheme), which–confusingly–has been renamed the National Health Protection Scheme (more on this later).

The Pradhan Mantri Swasthya Suraksha Yojna is supposed to set up new branches of AIIMS in the states. In addition to the 11 that exist, Jaitley announced setting up of two more AIIMS, in Jharkhand and Gujarat.

Instead of opening new institutes, and investing about 8% of the health budget (Rs 3,975 crore of Rs 47,352 crore) to do so, the government should ideally focus on making sure that the ones already opened are functioning.

Rs 3,000-crore increase to convert health sub-centres to health and wellness centres

Another significant increase of about Rs 3,000 crore is under the "Health System Strengthening" sub-head of NRHM. This is likely to be allocated to another pronouncement: Converting 150,000 health sub-centers nationwide into "health and wellness centres".

Again, this is not a bad idea, since functional sub-centers can take primary healthcare closer to where people live. But with no plan for this transformation made available–not even how many will be converted this year–Rs 3,000 crore appears inadequate.

For example, even if 25% of the increased allocation under this sub-head is to upgrade sub-centres, no more than Rs 60,000 would be spent per sub-centre.

So, while the current budget's health proclamations are apt, the funding increases for issues of low health priority are unlikely to make a significant impact on the overall well-being of India's people.

(Mohan formerly coordinated health and nutrition programmes for UNICEF's country office in India and is the co-founder of Basic Healthcare Services, a nonprofit that offers low cost, high quality primary healthcare in rural under-served communities. He is also Director, Health Services, of Aajeevika Bureau, a nonprofit that provides services to labour-migrants.) An Indiaspend story.

( is a data-driven, public-interest journalism non-profit. is fact-checking initiative, scrutinising for veracity and context statements made by individuals and organisations in public life.)

          Rebuilding Mobile Women's Health Clinics in Haiti        

PROFAMIL Haiti has provided sexual and reproductive health services in Haiti since 1984. This organization is part of a 40 member organization network called International Planned Parenthood Federation/Western Hemisphere Region (IPPF/WHR). The program in Haiti has three clinics, but the ones in Port-au-Prince, and Jacmel were completely destroyed by the earthquake as you can see by the photo below.  

Photo from International Planned Parenthood Federation/Western Hemisphere Region showing the complete devastation of its PROFAMIL Haiti clinic.

In an email interview, Laura Zaks, Public Affairs Coordinator, shared with me this sad story of devastation and the urgent need for funds to help PROFAMIL resume services through a temporary static clinic and Mobile Health Units to deliver services in tent cities where displaced persons have gathered.

1.   How did the earthquake impact PROFAMIL Haiti's work?

PROFAMIL’s clinics in Port-au-Prince and Jacmel have been destroyed, although a small amount of equipment and supplies has been salvaged.  Unfortunately,  many supplies remain trapped in building rubble with conditions too dangerous to access, particularly in light of the aftershocks. In addition, one staff member, the Director of Finance and acting Executive Director has passed away and at least several staff members have been injured, though a full report on the health and well-being of all staff and their families in both cities has not yet been received. 

2.  What's needed to rebuild the program?

IPPF/WHR has put together a proposal for funding from various donor sources totaling $2,500,000. This is based on the immediate needs over the next three to six months for human resources, site operations/communications and logistical support, transportation, and medical and surgical supplies.

Given the lack of physical clinics in Port-au-Prince and Jacmel and with the structural integrity of standing buildings uncertain, PROFAMIL is coordinating to offer basic primary health care and sexual and reproductive health services via several modalities, including:

• PROFAMILIA in the Dominican Republic has been coordinating with partners in deploying mobile health unit teams across the border to Haiti to conduct an initial assessment of key areas of need and to begin providing health services.  Currently, the majority of international assistance is concentrated in Port-au-Prince, with many unmet health demands in the areas surrounding Leogame, Matrissals, Jacmel, Petit Goave and Grand Goave.  These mobile health unit teams, consisting of medical doctors, nurses, and volunteer staff, have extensive experience in working with Haitian immigrants living in the Dominican Republic.  

• PROFAMIL staff and community health promoters in Jacmel and Port-au-Prince will organize mobile health units to bring primary health care, obstetric care, family planning and HIV prevention services to community-based sites, including tent cities and other temporary shelters that have been set up in and around both cities. 

• Though its physical clinics in Port-au-Prince and Jacmel are too damaged to resume operations, PROFAMIL will seek to establish temporary service provision facilities in fixed physical structures only as appropriate and based on structural assessments of their safety.

3.  How can people contribute?

We have set up a donate page on our website where secure donations can be made from any country. 100% of the money collected through this site will go towards getting PROFAMIL’s clinics and mobile health units up and working as soon as possible. The link is: and it is also accessible from the IPPF/WRH homepage:

3. Are you using social media to get the word out?

Yes, we have been using Face Book and Twitter to get the word out to contacts there. We have been posting updates periodically on these sites to share news and photos as well as the link to our donation page.  We can be found on Face Book at: and on twitter at:

We also have an online advocacy center: We have mobilized our online membership from this center by sending two appeals asking for donations. We will continue to update our membership as we receive further news from our partners on the ground.

4.  Please describe to my readers the connection between sexual reproductive health services and poverty reduction.  

PROFAMIL’s work has always been closely linked to poverty reduction efforts within Haiti. This brief slideshow gives a good picture in the link between sexual reproductive healthcare and poverty reduction. Haiti is one of the poorest and least developed countries in the Western Hemisphere. Infant and maternal mortality rates are the region’s highest, and Haiti’s devastating HIV/AIDS rate is second in the world only to Sub-Saharan Africa. 2006 data indicates that only 28% of the population uses modern contraceptives. Less than one-half of all births are attended by a skilled health professional. 

PROFAMIL is one of Haiti’s largest nongovernmental sexual and reproductive health providers. Its clinics, community distribution points, and mobile health units provide hundreds of thousands of sexual and reproductive healthcare services annually. For 25 years, PROFAMIL has provided low-cost, high-quality healthcare services including family planning, early detection of breast and cervical cancer, pre-and-post natal services, and voluntary testing and counselling for HIV/AIDS. In rural areas, a network of health promoters and mobile health clinics provide family planning and basic health care-often the only healthcare available in these remote communities. They recently inaugurated new clinics in Port-au-Prince and Jacmel, to better serve their increasing patient base. Given the massive socio-economic and health care challenges facing the country, PROFAMIL’s work has been and will continue to be tremendously important in future development efforts in the country. The stories from the field that I pointed to above further reinforce this connection between PROFAMIL and poverty reduction efforts in Haiti.

PROFAMIL has a four-star rating from Charity:Navigator

Beth Kanter, BlogHer CE for Nonprofits, writes Beth's Blog

          Comment on Illegal immigrants detained along Saudi, Yemeni border 2011 by Glen C. Carey        
Most of the migrants that I met were crossing the border for economic reasons, caused by political and economic instability in the countries. A large number of Somalis and Ethiopians are also trying to get across the border. I don't think Saudi Arabia would accept large-scale political refugees from Yemen or elsewhere. They would view it, I think, as potentially destabilising. They do provide them with basic health services before sending them back across the border. Not sure what the latest view is from the UNHCR on Yemen. Sure it isn't good.
          Fair Trade Mangoes: Delivering Flavor and Impact        

This guest blog post was written by Gesner Cledo Nozil (Nozil), a part-time field staff member for Fair Trade USA who works with mango producer groups in Haiti. Nozil has a long history working with mango producer groups in Haiti, especially in developing systems and processes to help them earn organic and Fair Trade Certification. As a field staff member, he works to ensure that trainings are completed, Community Development Funds are correctly spent and that the Fair Trade Committee has plenty of support. Nozil is originally from Jacmel, Marigot, Haiti, a small town that is a coastal community west of Port-au-Prince.

The mango tree is one of the most beautiful trees in Haiti. More than a hundred varieties of mangoes are grown throughout the country. Thanks to Fair Trade, one such variety, the “Madame Francique” or Haitian Francique mango, now represents a better future for more than 1,500 Haitian mango growers and their families.

The Fair Trade Mango, Unpeeled

Fair Trade Certified mangos arrived in the US market in 2012. Since that time, these mangos have come to symbolize a wealth for the country, and this knowledge motivates mango growers to continue working towards their own development.

Fair Trade mango growers in Haiti are scattered across ten different municipalities (communes) throughout the central and northern regions of the country. Under the Fair Trade system, these growers are divided into ninety different groups.  Each of these groups has its own representative committees including:

  1. A Trade Committee, which is responsible for coordinating the harvesting and selling the mangos to exporters.
  2. Fair Trade Committee, a democratically elected body that is responsible for managing the Community Development Fund, extra income earned for every Fair Trade Certified mango sold.  This Fund is used to address critical community needs, like education and healthcare.

A recent needs assessment of each group revealed that mango growers throughout Haiti face similar challenges. Many lack basic health care and clean drinking water. Illiteracy and food insecurity are also common.  Poor infrastructure and road conditions can also make it difficult for growers to transport their products to exporters.

Fair Trade in Action 

Fair Trade allows mango growers to address these and other issues. Some tangible improvements that the mango growers enjoy include:

  • The creation of an associative and mutual aid structure
  • A better price (up to 60 percent more) than they would for a non-Fair Trade Certified sale.
  • Training sessions to help mango growers maximize harvest yields and quality
  •  Motivation to plant more trees to increase their yield, which helps offset the significant deforestation that exists throughout Haiti
  • The opportunity to send their children to school with support from the Community Development Fund.
  • Additional community development projects through the Community Development Fund, including installation of water wells, scholarships, construction of roads and public staircases, a peanut seed program to diversify crops, and more.

Looking Ahead

The Fair Trade program in Haiti should be encouraged as it significantly benefits mango growers. We’ve made a great deal of progress, but further action is needed to strengthen and support the sustainability of the program in the long run.

Actions to be taken to ensure the sustainability of the program include:

  • Creating interactive trainings that increase retention. This is especially important considering the high levels of illiteracy among mango growers.
  • Strengthening the capacity of all the committee members to better ensure the future of the program.
  • Increasing harvest quantities by providing tools and trainings that facilitate harvests and support effective transport of mangos.  

These changes will not happen overnight, but we have faith in the program and where we’re heading.  Every penny that mango growers earn through the Fair Trade program counts for them, their families and the development of many communities throughout Haiti.

Fair Trade Certified mangoes from these dedicated Haitian small farmers are packed and exported by Ralph Perry Exports in Port-au-Prince, and sold under the Tropic Trade LLC label in the US. You can find these impactful and flavorful mangos at your local Whole Foods now! 


          Malawi Times Special Report        
Mulanje is a remote rural district in Malawi consisting of 673,000 people greatly affected by extreme poverty and inadequate health infrastructure. The region’s under-resourced healthcare facilities struggle to meet high demands for care. ETAF has been funding quality village-based health services delivered by our implementing partner, the Global AIDS Interfaith Alliance(GAIA), since 2008 through a system of 5 mobile health clinics providing basic health services in areas of need selected by the government District Health Office. Last September we treated the mobile clinic program’s one millionth patient visit. Designed to de-stigmatize HIV testing and treatment, the GAIA Elizabeth Taylor mobile clinics integrate HIV services into an array of primary care services, allowing GAIA’s medical teams to test and treat for a variety of serious, and often deadly, illnesses. Provision of basic health services reduces the stigma associated with seeking HIV Testing and Counseling (HTC) and supports our primary mission of HIV testing and treatment.
          Dont You Want to Cleanse Yourself and Find Your Basic Health Level        
Have you every thought about what your basic health should look like? For this report I am going to assume that you really have not given it much thought. On the other hand if you have this report should also be on interest to you. Another term I like to use is “Baseline of Your […]
          Good news from Afghanistan, part 16        
Note: Also available from "The Opinion Journal" and Winds of Change. As always, big thanks to James Taranto and Joe Katzman for their support of the series, and to all my readers and fellow bloggers whose encouragement has kept it going for over a year now.

Across Afghanistan, good news for the farmers, and the rest of the population:
The country's farms are alive again.

Seven years of drought had left fields monochrome plains of brown dust. But good snows and rains have many Afghans seeing color again -- seas of golden wheat undulate in the breeze, green apricot trees are plump with yellow fruit, melons of every hue dot fields.

It is much-needed relief for impoverished farmers as well as the estimated 3.4 million Afghans who have been relying on food handouts from overburdened international aid groups.

One wheat farmer sees the end of the drought as a sign that God is pleased with the country's fledgling democracy.

"Since the fall of the Taliban, Afghanistan has started to recover from the drought and people's lives have been getting better," said Fazah Rahman, 36.

"In previous years, no one even bothered to plant crops because our lands were dry like a desert, but that has all changed and everyone is sowing their land," he said.

Mohammed Sharif-Sharif, a senior official at the Agricultural Ministry, said the harvest is exceeding expectations.

"This year, we will be in need of less food aid from other countries," he said. "In the past seven years, nearly all our wheat was imported. But fortunately, it will significantly drop this year."
Whether or not God is indeed finally smiling on the long-suffering people of Afghanistan and blessing their new democracy with rain, the things are definitely becoming interesting for this, one of the poorest countries in the world. With parliamentary election coming up soon, the world's attention is slowly - though one fears, judging by the past experience, briefly - returning to Afghanistan. The political, security, economic and social challenges facing the country are enormous, but progress have been slowly and often painfully made, much of it missed by the media, and thus the Western audiences.

If you have been following this series for the past year or so, this will not come as a surprise. Below, another four weeks's worth of stories from Afghanistan, which so often got lost in the usual media chatter about drugs and violence.

SOCIETY: The authorities have officially announced on August 15 the start of the election campaign:
"The official campaign period for the Wolesi Jirga, or lower house, and provincial-council elections will begin on 17 August," UN-Afghan Joint Electoral Management Body spokesman Sultan Ahmad Baheen said. Candidates will be allowed to campaign until 15 September, when a 48-hour moratorium will be imposed. More than 10 million Afghans are reportedly eligible to vote. Candidates will be allowed to hold rallies, distribute posters and leaflets, and appear in private and state-run media. 'Each Wolesi Jirga candidate will be allocated an advertisement of five minutes to be broadcast twice on radio or one advertisement of two minutes to be broadcast twice on television,' Baheen said. Baheen said candidates for provincial councils will get one advertisement of four minutes broadcast on radio or one advertisement of two minutes broadcast on television.
More on the election on the airwaves here.

And so, one year later, the Afghan authorities and the international community are facing up to the logistical challenge of another election:
Afghanistan is preparing for landmark parliamentary elections using a combination of stone-age and modern technology to get polling stations open in under six weeks time.

Mountainous and remote terrain, low levels of literacy and the sheer number of candidates -- almost 6,000 -- all add up to one of the most difficult elections the international community has ever organised.

"I don't think the United Nations have ever seen an election like this, with up to 400 candidates on each ballot paper," Julian Type, of the UN-backed Joint Electoral Management Body [said]...

Despite the challenges and the threat of violence from increasingly active Taliban militants, officials said they thought the lower house and provincial council elections on September 18 would go ahead on time.

"We are very confident we will be able to deliver the operation successfully and have all staff... in place," James Grierson, electoral head of logistical support, told a news conference in Kabul.

Some of Afghanistan's remote mountainous districts are only accessible by donkey, while airplanes must be used to freight the 135,000 ballot boxes, 140,000 bottles of ink and 403 tons of furniture to many of the country's 26,000 polling stations, the electoral body said.

Fourteen cargo planes will make deliveries across Afghanistan, in addition to the 1,200 deliveries by cargo trucks and flights by nine helicopters to remote areas not accessible by road.

"The topography dictates that we will have to use air, road and even donkeys to distribute our material across the country," Grierson added.

The furniture must be flown into Afghanistan for this election because the chairs and tables used at the country's first presidential polls in October have already been donated to local schools.
Being any one of the 6000 candidates is not the safest occupation in Afghanistan, but perhaps the most courageous among the lot are women:
Three-hundred-twenty-eight of the parliamentary candidates are Afghan women. Another two-hundred-thirty-seven women are provincial council candidates. “I want basic human rights for men and women,” says Sabrina Sagheb. Ms. Sagheb is the head of the Afghan Basketball Federation and a representative of the International Olympic Committee. She says she hopes to help end practices such as forcing women into unwanted marriages or forcing them to wear burkhas.

Journalist Noorzia Charkhi hopes to represent her native province in the new parliament. But like a number of Afghan women candidates, her life has been threatened. “I’m not going to quit," she said, "because I want to show people that a woman should be able to do these things.”

Extremists set fire to parliamentary candidate Zobaida Stanekzai's front door. “They were trying to scare me into dropping out,” she said, “but my decision to be a candidate is unshakeable.”
Meet one of the candidates:
Sitting on the floor of a nomad's tent on an August morning, out of the searing sun, an election candidate was making her pitch to a group of women, children and old men clustered around her.

Fareeda Kuchi Balkhi, who wants to represent Afghanistan's nomadic tribes in Parliament, campaigned recently among Kuchi tribesmen in Kabul.

"I want to serve you. I know the pain in your hearts, and if I do not serve you, I pray to God not to grant me success," she said. "I want schools. I want grazing lands for the Kuchis. I want mosques, clinics, we should have midwives and women doctors," she said, counting each item on her fingers. "I want you to have a peaceful life."

The candidate, Fareeda Kuchi Balkhi, is one of seven women campaigning to represent Afghanistan's nomadic tribes, known as the Kuchis, in the Parliament to be elected Sept. 18. Barely 4 feet 6 inches tall, with indigo tattoos marking her forehead and chin, and wearing a black veil and the traditional red and gold embroidered dress and baggy pants of the Kuchis, Mrs. Balkhi is undeniably a true representative.

Before the official opening on Aug. 17 of the election campaign, she traveled from her home in northern Afghanistan to campaign among the nomads who have pitched their tents on the dusty plains around Kabul, the capital.
While candidates campaign across the country, efforts are being made by the authorities to further educate the people about the election. Read this story about Afghanistan's only election info line:
When the centre opened last month, it handled nearly 500 calls a day on six telephones, said Abdul Manan Danish, the official in charge.

"Now the number of people asking questions has gone up to between 700 and 1,500 a day," he said, attributing this rise, and the resulting need for more telephones, to the publicity given to the 180 number.

Nadia Sultani, a female worker at the centre, says the focus of questions has shifted in the time since they opened.

When people were having to register to get voting cards, most questions centred on how this should be done. Now, most callers simply want to know how to vote.
There are other ways of reaching and educating voters:
In Bamiyan Province, where two historic Buddha statues one stood, a crowd has gathered to watch a very modern performance.

The audience laughs appreciatively at the actors' antics, but the play has an entirely serious goal.

It's to show what Afghan voters will go through when they cast their ballots on 18 September -- and to encourage people to go to the polls.

Shamsuddin Yousofzai, dressed in a pointed green hat with red tassels, takes time out from playing a clown to talk to Reuters.

"The purpose of this show is to inform and teach people about elections and the benefit of elections," Yousofzai said. "Through these shows we give instruction to the people, and also it is a way of also entertainment and fun for the people of Bamiyan who have suffered so much and I am really proud to be a part of it."

The Joint Electoral Management Body is using more orthodox means to reach potential voters, with messages on radio, television, and newspapers.

But the more unusual mobile theater is playing a key role, too, according to university student Akbar Khan.
Foreign assistance also continues to arrive for the elections. The United States has promised an extra $8 million towards the cost of conducting the poll. The Netherlands is contributing an extra 4 million euros ($5 million) on top of a previous contribution of 4 million euros, towards the logistical support in the elections. New Zealand is giving $0.7 million and Australia $2 million (with another $5 million to go towards reconstruction). Germany is contributing $3.24 million, and Belgium $1 million:
Furthermore, the Federal Foreign Office is financing projects organized by several non-governmental organizations in the sphere of political education. For example, the Free and Fair Elections Association, an Afghan umbrella organization focusing on the training and the work of national election observers, is receiving EUR 250,000 [$309,000] from the Federal Foreign Office budget. The Independent Parliamentary Association of Afghan Women, which supports female candidates for parliamentary seats, has been allocated EUR 59,800 [$74,000].
In election secuirty assistance, Slovenia is sending its largest so far peacekeeping unit. Overall, NATO is sending additional 2,000 troops for the duration of the elections, bringing its total commitment to 11,000. "The additional [International Security Assistance Force] troops would be from ten nations - Austria, Belgium, France, Germany, Italy, The Netherlands, Romania, Spain, Sweden and the United States."

And in another good news for election-day security, the Taliban have announced that they will not be targeting polling stations.

In the meantime, a symbolic gesture will bind Asia's biggest democracy with one of Asia's newest:
Indian Prime Minister Manmohan Singh will lay the foundation stone for Afghanistan's Parliament building, a gesture more than symbolic for the two nations.

That the Prime Minister of the world's largest democracy will be asked to do the honours seems natural, but Afghanistan President Hamid Karzai's choice also shows the distance the two nations have travelled in recent times.

The fact that the task of building the Afghan parliament has fallen on India's Central Public Works Department may also be another reason why Singh will be asked to lay the foundation stone.

Singh is scheduled to be in Afghanistan between August 27 and 29. The visit itself will make history of sorts as Singh will be the first Indian Prime Minister in almost four decades to travel to Afghanistan. Indira Gandhi had last gone there in 1969.
Afghanistan is working to acquire a new national anthem:
Afghanistan is looking for a new national anthem that the government hopes will bring harmony to the country after nearly three decades of conflict.

A panel of poets, writers and musicians tasked with writing a new anthem after seeking the views of all ethnic groups released a draft this week for public comment.

The current anthem -- a jaunty, martial tune -- is sung in Dari, the language of the Tajiks who made up the bulk of the Mujahideen government that came to power after the fall of the Moscow-backed regime in 1992.

But many Afghans feel the lyrics -- which praise the Mujahideen for defeating the Soviet Red Army -- are now outdated, and they want something more broadly nationalistic that would bring together the country's varied ethnic groups.

Afghanistan had no national anthem from 1996 to 2001 under the Taliban, who banned all forms of music as un-Islamic.
Here is the text of the proposed anthem. On a related topic, one of Afghanistan's best known singers Amir Jan Saboori is visiting Afghanistan: "Saboori is meeting with government officials and academics in an effort to create music schools where a new generation can learn about the traditions of Afghan music while safeguarding its future. 'The best way to help strengthen the field of music in Afghanistan is to establish schools where musicians both living here and in other countries can come together and exchange ideas,' he says."

There's more along the same lines:
In what could be described as a brave move, artistes have called for the government to initiate concrete measures for promoting the performing arts in the southern Kandahar province - a former stronghold of the vanquished Taliban regime.

Renowned singers and musicians argue a mass exodus of artistes from the country - induced by decades of strife and total neglect of art at the official level - has retarded cultural activities in Afghanistan in general and the southern province in particular.

Abdul Qayyum Naseh, a widely-acclaimed singer who has educated hundreds of students including girls in Kandahar, underlines the need for official patronage of music and greater facilities like training centres and cash incentives for musicians.
Much effort is being made to train the much needed professional cadres, which over the past few decades have been decimated by violence and emigration. USAID is training government officials: "In July 2005, USAID delivered eight different training seminars for Ministry of Finance personnel. Training topics included: value-added tax, business receipt tax, income tax coverage, income tax liability, and fixed/presumptive taxes. Since the beginning of 2005, USAID has facilitated training for approximately 833 Ministry of Finance staff members by conducting 45 different seminars). In addition, comparisons between "pre" and "post" examinations illustrate a 25% increase in staff comprehension."

USAID is also supporting female judges: "Twenty female judges received USAID-funded laptop computers at a ceremony held July 26 at the Supreme Court. Chief Justice Shinwari presided and the Chief Administrator and Chief of Personnel were on the dais. In contrast to a desktop, the laptops can be carried between home and court, charged wherever there is power, and used for 2-3 hours during power outages. USAID is also providing computer training classes for the women judges at an off-site USAID-funded computer lab. This is part of a larger USAID effort to increase the capability of Afghanistan’s legal professionals."

Tax officials are also getting trained: "Twenty-three commerce and law graduates, nominated by the Finance Ministry as tax officers, completed three months training... This was the first batch of the tax officers being trained ahead of September 23, date set for implementation of the new taxation law."

Refugees continue to come back to Afghanistan, providing the authorities with the challenge of integration. Japan has donated another $2 million towards the cost of repatriation Afghan refugees from Pakistan. On a smaller scale, "The UN refugee agency... assisted 183 returning families with building material for construction of houses in Orgun district of the southeastern Paktika province."

Read also, how this international initiative is trying to forster good relations and cooperation in Bamyan province, not just between different ethnic groups living there, but also between the old residents and the returnees:
In the village of Sar-i-Qul Topchi, near Bamiyan town, men representing Hazara, Tajik and Pashtun communities have gathered in the home of Haji Abdul Mohammed for one of their regular meetings. The 22 men are members of the local peace committee created as a result of a UNHCR co-existence project, implemented by the non-governmental organization, Save the Children Japan.

Each committee member has received training in conflict resolution and attended workshops where co-existence issues were discussed. The committee is designed to complement existing village authorities such as elders and local councils known as shuras. Once formed, families are encouraged to bring their disputes to the committee. The grievance is then investigated by a working group of five committee members before a decision is issued.

In Sar-i-Qul Topchi, as in other communities of mixed ethnicity, disputes are more often about access to land or water than religion. A second phase of the co-existence project ensures that the root cause of the dispute is addressed. In this case, water pipes and a small dam are being constructed to improve the volume of water provided by a mountain stream which serves the communities.

The construction work is a joint effort between the UN refugee agency, UN Habitat and the Afghan government's National Solidarity Programme.

"The three-month building project is aimed at providing people in these villages with irrigation water, short-term job opportunities, and, of course, promoting co-existence among the different communities," says Mustafa Hussaini of UNHCR in Bamiyan.

For Amir Dud, a peace committee member, the end result is straightforward. "Having access to water means ending disputes among the different tribes in this area," he says.
In health news, USAID is helping to improve the quality of medical training: "To improve the capacity of health providers, USAID focuses on designing and delivering training and professional development courses. In June, a total of 571 doctors, nurses and midwives completed refresher training courses in newborn care, family planning, infectious disease and antenatal/postnatal care. USAID delivered Essential Obstetric Care (EOC) courses at Malalai Hospital, Kabul and Mazar-i Sharif Civil Hospital to update the knowledge and standardize the skills of 30 participants in key safe motherhood practices according to national clinical standards. In addition, a two-day community mapping refresher training course was conducted in Herat province for 30 staff from Herat and Faryab provinces."

USAID is also working to improve access to health care throughout rural areas:
USAID’s Rural Expansion of Afghanistan’s Community-based Healthcare (REACH) program sent monitoring teams to visit 65 health facilities and 803 community health workers (CHW) in Baghlan, Paktia, Herat and Ghazni between July 31 and August 13. During the same time period, approximately 6,700 basic health kits and 18,000 bars of soap were distributed to CHWs and provincial hospitals.

In early August, REACH conducted re-orientation seminars on proper case management of Acute Watery Diarrhea in the four main Kabul hospitals: Infectious Disease Hospital, Indira Ghandi Children’s Hospital, Maiwand Hospital, and Khair Khana Hospital. A total of 80 participants (doctors, nurses, and chiefs of service) were trained.

REACH is supporting the MOPH in the first revision of the original Basic Package of Health Services (BPHS), published and released in March 2003. The revised version, which reflects two years of BPHS experience and incorporates elements of care formerly designated "second tier" (i.e., mental health and disability) will be termed "BPHS-2005". In this revision, BPHS is expected to continue to be the foundation of the Afghan health system in providing quality basic health services to its primarily rural population for the coming years.
This initiative is also saving lives: "Since opening last week, the World Vision Afghanistan-sponsored neonatal unit in Herat has saved the lives of at least 20 newborn children. However, more funding is needed so the unit will be able to save even more children." In related news:
Midwives represent a new hope for the survivability of infants and mothers. Many rural communities in Afghanistan rely on midwives as the only professional care provider for pregnant women.

The Medical College of the University of Nangarhar in eastern Afghanistan graduated 61 midwives recently and about 200 students in other medical professions so far. This class of graduating midwives comes from Nangarhar, Konar, Laghman and Nuristan provinces.
In education news, USAID's help for Afghan education system continues:
As part of its comprehensive education program, USAID has printed and distributed 35.7 million textbooks for grades 1-12 since 2002. An additional 6.2 million have been printed and are ready for distribution. However, the Afghan government often receives specific and unexpected requests from its constituents. The following collaborative effort demonstrates USAID’s agility and dedication in helping the central government respond to provincial requests.

During a visit to Bamiyan in late July, Afghan President Karzai met with students who informed him that they were in need of more 8th and 9th grade textbooks. The president promised the students that they would have the additional textbooks within 10 days. Upon return to Kabul, the President informed the Minister of Education. USAID and the Ministry of Education (MOE) collaborated to ensure that the students’ needs were met within the deadline. At the time of the request, USAID’s printers had all the subjects needed for 9th grade. Another printer had printed 4 subjects for 8th grade. He agreed to immediately switch to print the remaining subjects needed for 8th grade. The partial set of 8th grade and all of the 9th grade textbooks were delivered to the MOE on August 2 and the remaining 8th grade textbooks will be ready by August 8 and will then be delivered to Bamiyan. The Minister was extremely appreciative of USAID’s ability to respond so quickly.
Young people are flocking to IT and English language courses:
Ten-year-old Asad doesn't look any older than his age, but he has already been offered work by several non-governmental organisations, NGOs. His secret? A strong command of English and some computer skills.

Just a few streets away, at 28-years old and with a degree in engineering from Kabul University, Abdul Hadi Shahidzai vainly looks for work in a land trying to rebuild from years of wars.

His problem? No English and little knowledge of computers...

Asad, a level four student at the private National English and Computer Centre in Kabul, is now expanding his computer skills. He is part of an army of young people who see this as their future.

The centre opens at six in the morning, and Asad arrives to polish his English before going to school for normal lessons, and then returning for computer studies at five in the evening.

"I have been asked several times by NGOs to work with them but I'm too young really, and my family wouldn't let me," he told IWPR. Every day outside this and hundreds of other centres in the capital and elsewhere, dozens of students gather in groups, practising their English or discussing computer programmes as they wait for classes where between 30 and 40 students, both male and female, work together.

The centres have mushroomed in the past four years, although some go back much further. The first such school, called Ariana, opened its doors as an English language school in 1971 during the reign of King Mohammad Zaher Shah.

Since the 2001 fall of the fundamentalist Taleban regime, with its ban on educating girls and prohibition of the internet, there has been a huge growth in computer courses. And as most IT lessons are given in English, the two skills go hand in hand.

Today, a total of 760 computing and English language centres throughout Afghanistan are registered with the education ministry, according to Sadruddin Ashrafi, the ministry's head of curriculum matters. Of these, he said, 235 are in Kabul.
India, meanwhile, is renovating Kabul's historic school:
The Habibia School here, one of Afghanistan's premier institutions devastated by the civil war and the diktats of the Taliban, has been restored to its former glory by a team of Indian engineers.

Indian Prime Minister Manmohan Singh, who will pay a two-day visit to Afghanistan Aug 28-29, will inaugurate the school building, restored at a cost of $5.1 million (Rs.220 million).

But the task of rebuilding the school was not an easy one. When the Indian team began its work, the four-storey building spread over 15,000 square metres looked like a building used for target practice for all types of weapons, ranging from AK-47 assault rifles to rockets.

Project director A.K. Aggarwal said his team removed 10,000 tonnes of rubble, including live and spent ammunition, from the building before beginning repairs.

Educationists say Afghanistan's former Taliban regime had killed the soul of the school when it issued diktats that forbade the teaching of subjects like science. It also sacked the highly respected principal, Sayed Naasir Askarzada.

Today the school has a brand new building, complete with the restoration of all damaged elements, new floors, marble walls in corridors, aluminium windows, a new central heating system, new furniture and laboratory equipment as well as a large computer room.
Elsewhere in the country, "the Afghan Education Foundation (AEF) has trained 800 teachers including 295 female on modern teaching methods and techniques in the southern Kandahar province." Also in Kandahar province:
The Ghazi Abdullah Khan School in the Spin Boldak district of the southern Kandahar province was inaugurated after reconstruction on Tuesday.

Reconstructed with financial assistance from an NGO, the school has 36 classrooms. Senior education department official Pir Mohammad told Pajhwok Afghan News the renovation work had been initiated last year.

Students' problems will be resolved with the opening of the school, he hoped, recalling around 1,600 pupils were enrolled in the school before the reconstruction work was launched.
Free from the Taliban suppression, Afghanistan's free media has a chance to develop and expand. Recently, Tolo Television, Afghanistan's private TV channel, has expanded transmission to cover Kandahar City. It's another step in the channel's short but successful history:
[Director Saad Mohseni] said their programmes were now reaching more than 13 million people across the country. He said apart from Kandahar, their programmes had been visualising in Kabul, Herat and Mazar-i-Sharif while it would cover the eastern city of Jalalabad within the next two weeks.

A statement issued from the TV station said Tolo TV also broadcasted via satellite across the region, covering Afghanistan, Iran, Pakistan, India, Gulf States, Turkey, and Central Asia...

Asked about the widespread criticism from clerics, especially the Ulema Council led by Afghanistan's Chief Justice Fazl Hadi Shinwari, Mohseni said 80 per cent of people were watching the programmes and they liked it.
And now Tolo is to give Afghanistan its own Oprah:
Afghanistan is to get its own Oprah Winfrey-style chat show touching on taboo women’s issues, a television station said... in a move likely to anger hardliners in the conservative Islamic nation.

Called Bonu, the Persian word for women, the show will be launched by privately-run Tolo Television, which has drawn condemnation from mullahs for airing music videos of scantily clad women and for accepting large US grants.

Tolo was the subject of international attention in May when the female host of its most popular music programme was found dead with gunshot wounds in a mysterious killing, for which no one has been charged.

The station said in a statement that the new chat show would examine topics such as education, changing social norms, marriage, leadership, motherhood and physical and mental health

Female host Farzana Samimi will be joined by psychiatrist Dr Yassin Babrak to talk about issues affecting women, it said.

“Our aim is to drive social change through open and frank discussions regarding the issues facing women in Afghanistan today,” Samini was quoted as saying. Tolo Television was launched in October 2004 and has become the nation’s most popular station, reaching an estimated 15 million Afghans in Afghanistan alone as well as others across the region by satellite.

Director Saad Mohseni said: “Our programming is about building Afghanistan’s future, that is why we have Bonu as well as our news and current affairs programmes examining the way forward.”
Meanwhile, in another recent initiative to help the development of Afghan journalism:
A new institute to promote investigative journalism will soon be established in Afghanistan.

The proposed institution, unregistered thus far, currently training 10 Afghan journalists on investigative reporting.

The moving spirit behind the project Abdul Ghafoor Liwal said this was the first venture of its nature in the war-ravaged country as compared to other states across the world. He said investigative reporting was a well developed technique in modern world playing a major role in solving problems of society.
Also: "Two Afghan trainers participated in a two-month training course for Asian and African journalists held in Berlin. The course, held at the International Journalism Institute (IIJ), got under way on June 8 and concluded on August 9, with 15 participants from Asian and African countries."

While some damage can't be unmade, some memories can be at least brought back:
When the former Taliban regime in Afghanistan destroyed two 1,600-year-old Buddha statues carved into Bamiyan Valley's soaring cliffs, the world shook with shock at the demise of such huge archaeological treasures.

Now, artist Hiro Yamagata plans to commemorate the towering Buddhas by projecting multicolored laser images onto the cliff sides where the figures once stood.

"I'm doing a fine-art piece. That's my purpose — not for human rights, or for supporting religion or a political statement," said Yamagata, whose other laser works include a permanent display at the Guggenheim Museum in Bilbao, Spain.

Against a canvas of desert darkness, 14 laser systems powered by solar panels and windmills will project 140 overlapping faceless "statues" sweeping four miles across Bamiyan's cliffs in neon shades of green, pink, orange, white and blue. Each image will continuously change color and pattern.
First Special Olympics have been held in Afghanistan in late August, with 360 athletes with intellectual disabilities participating in athletics, bocce and football. Says Mr Troy Greisen, Managing Director, Special Olympics Asia Pacific: "One of our goals in Afghanistan is to establish new local programmes in communities across the country. We are here to expand this movement and spread the message of hope to parents and families of persons with intellectual disabilities. Through these Games we will demonstrate that these capable individuals that have hurdled such difficult circumstances can not-only be proven as great athletes, but can also be fully accepted, empowered to serve as leaders and that their abilities can actually outshine their disabilities."

Lastly, Afghanistan gets its first Mr Afghanistan:
Khosraw Basheri feverishly pumped iron for years, toning his body so it rippled with muscle and veins. His hard work paid off when he claimed a historic title in his war-battered country -- Mr. Afghanistan.

The 23-year-old businessman from western Herat province flexed and grinned his way to victory Saturday in Afghanistan's first-ever national competition to select a top bodybuilder.

"I will never forget this day, the day I became Mr. Afghanistan," said Basheri, sweat and makeup streaming down his massive frame. "This has been my hope for the past two years, since I started preparing myself for this."...

"The most popular sport after football (soccer) in Afghanistan is bodybuilding," said Sayed Mohammed Payanda, secretary general of Afghanistan's National Bodybuilding Federation. "Most people in Afghanistan, especially young people, like bodybuilding very much."

It's so popular, in fact, that Arnold Schwarzenegger -- the former bodybuilder and movie star turned California governor -- is among the most widely recognized Western celebrities here.

Modern gyms and athletic clubs have popped up in many provinces in recent years, Payanda said, adding that some Afghan bodybuilders have returned from neighboring Pakistan and Iran since the hard-line Islamic Taliban regime was ousted in 2001 and President Hamid Karzai subsequently took office.
RECONSTRUCTION: Afghanistan's public finances are improving: "Afghanistan’s Ministry of Finance released total domestic revenue totals for the first 3 months of Afghan calendar year 1384. The total is now $77.16 million, a 40% increase from the same period last year (Afghan year 1383). Of the $77.16 million, customs operations represent 53% of the total figure, with $41.45 million collected within the initial 3-month period. Taxes account for 10% of total domestic revenue, with $7.7 million collected so far. This shows considerable progress from last year (1383) and is promising for the remainder of the year."

Foreign assistance continues to arrive. India is a major helper in rebuilding Afghanistan: "Prime Minister Manmohan Singh, carrying offers of fresh aid and seeking to blunt rival Pakistan's influence in Afghanistan, heads tomorrow to Kabul for the first visit by an Indian premier in 29 years... India, one of the six top donors to Afghanistan, has pledged S500m in aid to Kabul since 2002 and Singh would unveil fresh assistance of $50m during the visit."

During the Prime Minister's visit, three accords covering education, healthcare and agricultural research were signed between India and Afghanistan, and an extra $50 million committed by India towards reconstruction.

Spain is also contributing more resources towards reconstruction:
Spain will allocate 10 million euros [$12.3 million] for the first phase of developing Afghanistan's infrastructure, a Spanish Foreign Ministry official said.

The Spanish Agency for International Cooperation under the Spanish Foreign Ministry will allocate the money for constructing water supply systems, roads, and hospitals in the poorest province of Badghis in northwestern Afghanistan.

A Spanish Foreign Ministry official and four experts of the agency will arrive in the country in early September to oversee the restoration of Afghanistan's civil infrastructure, a plan suggested by Spain.

A total of 125 Spanish peacekeepers are already in the Badghis province, restoring health services, water treatment facilities, and roads.
Russia, meanwhile, is considering various options for debt relief to reduce Afghanistan's $10 billion debt burden. And here's a retrospective on the Japanese contribution so far.

But reconstruction is also a local effort: "More than 400 local representatives from around Afghanistan [met] in Kabul to exchange development ideas and experiences from around the country. They are all involved in development projects through the National Solidarity Programme, NSP, a flagship programme created by the Afghan Government with the support of the World Bank."

Under the Kabul Urban Reconstruction Project, "the World Bank has provided $25 million of interest-free loan to the government for bringing improvement in the basic urban services in the most vulnerable areas of the central capital."

A major infrastructure project is now back on track:
The Washington sisterhood's campaign against the Taliban, led by the Feminist Majority Foundation, had thwarted ambitious plans by the US energy firm Unocal to build a strategic pipeline across the wastelands of Afghanistan.

But what a difference a war makes. In the new Kabul, the $US3.8 billion ($5 billion) gas project is being resurrected and one of the finer pairs of hands on this dog-eared brief are those of Mary Louise Vitelli, a fortysomething New York lawyer.

She explains that in the 1990s she was fighting a very different war. Far from the battlefields of Washington, she was working in Russia, on a World Bank attempt to reform the former Soviet Union's antiquated coal industry.

What she remembers of the US capital makes her prefer Kabul.

"Washington was the most sexist place I've ever worked," she said.

"Here the minister sets a different tone. He has women in key senior jobs and I'm welcomed in the provinces. I'm the team leader and there is no problem."

Her boss, the Minister for Mines and Industries, Mir Mohammad Sediq, brims with the kind of confidence that separates the stayers from the faint-hearted in the global resource development race.

Afghan optimism about the Unocal project is understandable. If the pipeline goes ahead, the Afghan Government might make up to $US300 million a year (the equivalent of its ostensible budget) purely from transit fees along a pipeline that will enter Afghanistan's north-west corner, follow the ring road that skirts the spread-eagled Hindu Kush and exit through the still restive south-east...

Representatives of the four governments that are a party to the pipeline project - Afghanistan, India, Pakistan and Turkmenistan - are to meet in the Turkmen capital, Ashgabat, soon, where they hope to sign off on Turkmenistan's capacity to supply gas and Pakistan's willingness and ability to buy it, and on the outline of a private consortium to build and operate the pipeline.
In other power news, a new Indian infrastructure project will bring more electricity by the end of the decade:
Power Grid Corporation of India Limited (POWERGRID) - a government of India enterprise - has bagged... international transmission project in Afghanistan. POWERGRID and ministry of external affairs, GoI, entered into an agreement to this effect on August 12...

Giving details the statement said the entire expenditure on the project shall be borne by GoI under the assistance programme to Afghanistan. The project will strengthen Indian presence and involvement in the reconstruction process in Afghanistan and will enhance international profile of POWERGRID. The project is scheduled to be completed by February 2009.

The project will enable Afghanistan to imort power from generating stations located in Uzbekistan to Kabul to bridge the gap in demand and supply. The project comprises construction of 220 KV double circuit transmission line from Pule-Ku i to Kabul (202 km) and new 220/110/20 KV sub-station at Kabul.

The transmission line is passing through snowbound tough hilly terrain, steep hills with altitude ranging from 1800 m to 4000 m above see level and temperatures as low as 30 deg C (a part of Hindu-kush mountain range). The materials of about 15000 MT required for the project shall be transported from India to Afghanistan by sea route via Bandar Abbas port in Iran and thereafter through 2500 km roads of Afghanistan.
In another cross-border project that could bring benefits to locals:
An Iranian delegation Wednesday held talks with provincial authorities on a proposed gas pipeline from Turbat-i-Jam to the western Herat province.

Representatives of the Non-governmental Gas Producer Association of Iran said they would launch the project following a green signal from the Iranian government. The delegation said the Herat officials would be informed in the next two weeks.

Speaking to Pajhwok Afghan News, Herat Mayor Mohammad Rafiq Mujaddedi said the 13-member team called on Governor Syed Hussain Anwary and expressed willingness to launch the project. He said the two sides agreed on signing a formal agreement after the go ahead from the gas and petroleum ministry of Iran.
In communications news, the cell phone network keeps growing:
Five more cell-phone companies have expressed their willingness to launch services in Afghanistan, officials told Pajhwok Afghan News.

Al-Kozay, National Kam International, Watan Mobile Company, and two firms from Germany and the United Arab Emirates (UAE) are ready to launch operations in Afghanistan, where Roshan and the Afghan Wireless Communication Company (AWCC) are already active.

Earlier, the Communication Ministry had announced 80 companies were interested in getting licenses for launching services in Afghanistan. But in the final analysis, five of them have stepped forward to accept the government's terms and conditions.
The previously foreshadowed 300 public phones have now been installed across the capital: "Three hundred new telephone booths have been installed in the Afghan capital, Kabul. During the inauguration ceremony, the Afghan minister for communication, Amirzai Sangeen, explained that half the phone boxes were placed in the city's shopping areas, while the rest were installed in the more densely populated areas of the capital. Built by the German company Siemens, the booths cost 200,000 US dollars and were paid for by the Afghan government and installed by a local private company."

Here's another report about the Kabul public phones:
Like strange hooded aliens, sparkling yellow telephone stands have sprouted in Kabul's dilapidated streets, drawing curious looks and hesitant attempts to use them.

“Brother, how can I drop the coin in the phone?” a young man asked Jamaluddin as he left his work at the education ministry.

Jamaluddin explained that the new phones accepted pre-paid cards rather than coins.

Standing slightly taller than a man, the 300 new phones - comprising a central pillar and a cobra-like plastic shelter for the handset - bring a touch of progress to this city of more than three million people.

Half the phones are spread through the capital's streets, while the other 150 have been set up in ministries, public hospitals and police precincts for public use.

The phones, which went into service on August 11, have brought renewed hope of a way to communicate for the capital's countless poor, who cannot afford mobile phones or the more expensive Public Call Offices, PCOs.

Afghanistan got its first coin-operated public telephones in 1973. At that time, a call needed a single one-afghani coin fed into a slot. In addition to Kabul, the phones were installed in Herat, Kandahar and Mazar-e-Sharif.

But like so many other public services, the phone system fell into disrepair after the collapse of the communist regime in 1992 and in the subsequent fighting between rival mujahedin groups that devastated Kabul .

Now an Afghan-American company called Afghan Pooshesh (Afghan Coverage) has set up the network of public phones at a cost of 180,000 US dollars. The money has come from the communications ministry, which has signed an installation and one-year maintenance contract with the company.
In transport news, the Asian Development Bank will be funding the development of the civil aviation sector:
The Asian Development Bank will help improve Afghanistan's air transport system by boosting management of the country's civil aviation administration, through a technical assistance (TA) grant approved for US$1 million.

The TA will improve the air safety oversight of the Ministry of Transport (MOT) and maintenance of a financial management system that will be developed to enhance financial governance of airport operations.

It will help develop air safety regulatory frameworks to be adopted in a phased manner in coordination with other aid agencies, with the ultimate goal of establishing an independent civil aviation authority. It will also help draft a civil aviation act that will remedy the deficiencies of the existing acts, as well as other civil aviation regulations and safety orders needed.

Work manuals for airworthiness control, flight operations inspection, personnel licensing, air operator certification, and accident and incident investigation will likewise be developed.
There's also action on provincial roads: "The Afghan government, in collaboration with the World Bank, will is to start the reconstruction of 260 kilometres of roads that lead to villages in seven provinces, officials said on August 27. An agreement was signed between the ministers of rural rehabilitation and development, public works and the World Bank on the 15 million US dollar project. Sohrab Ali Safar, the minister of public works, said the programme will cover the reconstruction of roads for villages in Kabul, Herat, Bamian, Kunduz, Logar, Paktika and Parwan provinces, and will create jobs for 600,000 people."

Agriculture is still the major industry and the main employer throughout the country. Afghanistan's only sugar factory is planning not only to revive the local economy (and an old local industry) but also do its bit in the fight against drugs:
The factory is ready, the workers trained, but the rest is something of a gamble.

Will the farmers of Baghlan province, northwest of Kabul, plough up their poppies and swap the rich harvest of opium for sugar beet?

Many say that they will, even though poppies have been a reliable source of income over the years of jihad and civil war.

At a recently refurbished factory, the only sugar plant in Afghanistan, manager Abdul Karim Wazeri said he is trying to persuade all the farmers of the northern provinces to plant beet. If they do, he has pledged to buy their entire crop for the next two or three years.

He told IWPR that nearly 200 workers were already at the factory, being paid a wage of three US dollars a day, and that the plant could process 100,000 tonnes of beet a year from which 15,000 tons of sugar would be produced.

At least one farmer appears ready to make the switch.

"Even though we'll earn less than with poppies, it will be much better because we can cultivate and sell sugar beet freely, without any threats or restrictions," said Taza Mir, a 63-year-old farmer in the province.

Taza Mir is old enough to remember the days when beet was the major crop in Baghlan and the province was noted for its sugar.
There is also assistance under the US Department of Agriculture's Food for Progress program:
The U.S. Department of Agriculture today announced that it will donate 5,150 metric tons of soybean oil and 10,000 tons of soybeans to International Fertilizer Development Center (IFDC), a private voluntary organization, for use in Afghanistan.

IFDC will sell the soybean oil in Afghanistan, and sell the soybeans in Pakistan. Proceeds will be used over a two-year period to fund its technical assistance and market development activities designed to increase the quality and quantity of local wheat produced by the Afghan milling industry. IFDC also will provide a portion of the proceeds to the Afghan Ministry of Agriculture and its extension staff to conduct research trials to improve high-value crops. The proceeds also will be used to conduct on-farm demonstrations to improve crop technology for key high-value foods and wheat crops in seven provinces in southern Afghanistan.
USAID, meanwhile, is trying to assist the revival of the dried fruit and nut industry:
Before the Soviet invasion, exports of dried fruit and nuts were significant to the agricultural economy in Afghanistan. Today, as Afghan producers
          The Gap        
Natasha Vos

There have been a lot of conversations this year about the financial model that AmeriCorps VISTA uses to pay its members. Currently, the stipend for the year is set at 105% of the poverty line of the county that the member is serving in. For me, that means I can expect to receive around $11,400 for the year, or $442 every two weeks. The logic behind this is that we can have (in at least a small way) a shared experience with those living in the communities we serve. We intensively plan out budgets, enroll in the Supplemental Nutrition Assistance Program (SNAP), seek out public transportation, and look for cheap housing. If anything, my experience has informed me that those living in poverty are actually the best at using financial resources, because they have so little to work with in many cases. I recognize the limitations of this model in its inability to account for factors such as family size and support, transportation, personal, physical and emotional health, education, etc. which is why I say a shared experience, 'in at least a small way'. Many AmeriCorps members elect to go through application processes for benefit programs such as SNAP, and recently the Healthcare Marketplace.

This year I turned 26. The only birthday milestone that you do not look forward to because you officially get the boot from your parents’ health care plan. As an AmeriCorps member in North Carolina, I fall in this health care limbo referred to as “the gap.” Try to follow me here because it gets a little complicated. I exist in an income level with my stipend that is too low to qualify for monthly federal tax credits to help me pay for the most basic health care plan. However, because North Carolina as a state did not expand Medicaid, this same income level (105% of the poverty line in Forsyth County), was too high to qualify me for Medicaid. The consolation prize? An exemption that would prevent me from being penalized on my taxes for not having health care.

Fortunately, being a second term AmeriCorps member I had earned my educational award of $5645 to be used towards my existing student loans. Because the education award is a taxable source of income, using it entirely this year, bumps me up into the next income bracket, qualifying me for tax credits and an affordable health care plan. Fantastic right? Here’s the drawback: the education award is a taxable source of income that taxes have not been taken out of, so I will end up owing several hundred dollars for using it all this year in addition to state taxes I will owe, because they are not taken out of our weekly paychecks. Many AmeriCorps members choose to use their education awards slowly over time to pay a minimum in taxes on them. I had to essentially do a cost benefit analysis. Not having health care was not an option. Purchasing my own plan would have cost me $200 per month, but using my education award would result in $300-400 in taxes once. Easy choice, but I’m still forking over a couple hundred dollars, which for someone making $11,400 a year, is challenging.

AmeriCorps offers its members a $6600 allowance per year to be used on approved health care costs, but you have to a have plan first. This is not a critique of AmeriCorps or its policies. This is using myself as a personal example to demonstrate challenges that low income individuals face to providing basic care for themselves and their families. I had the luxury of choosing to use my education award to ensure that I make enough to qualify for tax credits and an affordable health care plan. There are millions of families and individuals that do not have this luxury. The Affordable Care Act has provided healthcare to millions in this country for the first time. It has withstood many challenges to its constitutionality, and that should be (and has been) celebrated. But cracks have appeared that allowed states to choose whether to expand Medicaid and in over half of the states, that choice was no. However you feel about state’s rights, the fact is that because of North Carolina’s decision not to expand Medicaid millions of individuals and families still do not have health care. Progress is never content and we need to continue to find these gaps and close them.

          November Jobs Report: Solid Growth        
Copyright 2015 NPR. To see more, visit Transcript STEVE INSKEEP, HOST: The U.S. government reports another month of solid job growth. It happened in November, when employers added 211,000 jobs, according to the government. That sets the stage for the Federal Reserve to raise interest rates later this month. NPR's John Ydstie reports. JOHN YDSTIE, BYLINE: Job creation was widespread across the economy in November, with only a couple of industry sectors lagging. Mining, which includes the oil and gas industry, continued to lose jobs because of the oil glut, and manufacturing was down slightly. It's being hurt by a strong dollar and weak global growth. Wells Fargo chief economist John Silvia says the strong job growth, despite these factors, signals the basic health of the U.S. economy. JOHN SILVIA: We can worry about Europe and China and Brazil and everything else, but it does seem like the domestic U.S. economy is doing pretty well, thank you very much. YDSTIE: Silvia says continued job
          Educational Sector Reforms for Transformation of People from Delusion to Dynamism to Development to Decent Living        
Educational Sector Reforms to End Poverty, Hunger, Corruption & Neo Feudalism; to Empower the Suppressed Downtrodden Sections for Establishing Social Justice & Social Equality; to Ensure Dignity of Labour Prevails; to Enforce Transparency & Accountability in Systems for Occurrence of Sustained Development, Inclusive Growth

for ensuring Every Citizen know how to Read & Write Regional Language; Basic Hindi & English; Indian History, Traditions, Culture; Basic Health Care, Food & Nutrition; Constitutional Rights & Safeguards; Duties & Responsibilities of Elected Representatives & Civil Servants; Social Obligations of Citizens; Basics of Banking & Financial Management, Environment Science, Energy Conservation; Religion & Spirituality;     Basic Operations of Smartphone & Computers All in Regional Languages; Incentives for Learning & Qualifying in Basic Education; Mandatory to Qualify in Basic Education for Employment, Entrepreneurship and to  Contest Gram Panchayat to Parliament Elections   
for particle knowledge about various sectors like Agriculture Production, Construction, Manufacturing, Services; for understanding realities of Livelihood of various Professions, Section of People; for Learning & Practice of Sports, Indian Traditional Art/Music/Dance, Martial Arts, Disaster Management, Community Policing; Hindi, English & Local Regional Language, Basic Computer Education, Orator Ship & Leadership Development; 70% Weightage Marks for Regular Subjects & 30% Weightage for Social Education; Grading System in place of % of Marks; Means to Reduce Weight of School Bags through Use of  Laminated Papers of Each Chapter, Each Subject Wise, Blank Papers, Providing Nutritious Balanced Lunch & RO Water at Educational Institute; Standard Lightweight School/Collage Bag with GPRS System; Standard Uniform, Rain Coat, Sweater, Cap, Green Buildings with Medicinal Value Plants; mandatory Health care at Educational Institute; Uniform Working Hours,  Uniform Syllabus & Uniform Examination System, Valuation of Answer sheets in Digital way to Contain Manipulation; Detention System; Digitalisation of Educational Records; Unique Identity Number for Each Student for Multiple Benefits, To Contain Frauds; Community Study centres for Downtrodden students to study in peaceful atmosphere, Ban on Loud Music in all residential habitations / religious places/functions; mandatory maintenance of inventory of belongings by students: mandatory bank account for all students; Ban on personal motored vehicles to educational institutions only mass transport/bicycle; Mandatory Religious Teachings, Yoga, Breathing Exercises, Parents Pada Pooja & Guru Pooja: Mandatory to rise a Plant a year in Public Place, Rise of Tulsi Plant, Cow, Pet Animal at Home;  Mandatory every student should clean class room once in a month, Toilet once in six months; Student Committees  with 10% students on rotation in every month in place of class leader to provide opportunity, develop leadership qualities; Parents Committees  comprising of 10% of strength on rotation every month to monitor students activities; Parents Monitoring use of Mobile Phone, Social Media, Internet through Default Settings  CC to Parents; Measures to contain Addictions Smoking, Drugs, Pre Matrimonial Sex, Adultery; Monthly Conduct Certificate from Parents & Care taker Teacher in Digital Format; Canning, Beating, Abusing Students by Parents/ Teacher to be Criminal offence; Establishment of Giant Science Laboratories in All District for Practical Learning of Science Principles by Students; District Wise R&D Centres with State Art of Equipment, Software for Freelancers with Innovative Ideas to do R&D; Government Provide Seed Fund for Students/ Freelancers  Social Innovations to Establish Social Enterprises; Mandatory Surrender of Used Computers & Mobile Smart Phones to Purchase New, to Contain E-waste &  Refurbished Computers for Basic Computer Education for all Citizens, for use by  Students, SHG, Micro Enterprises, and Rural/ Slum House Holds to Empower the Downtrodden Sections Use Digital Power of E-Governance & E-Commerce; Free Digital Space for Every New Born Child & Student to Store Information Digitally forever;All Reforms for Transformation of People, from Delusion to Dynamism to Development to Decent Living

 Pradeep Kumar Kunche;;



[2] Mandatory basic education for all citizens with incentives for learning & qualifying in basic education; mandatory to get qualified in basic education test to contest for any election from gram panchayat to parliament, also for employment in government & private; also for entrepreneurship; all  empowering people for better life. 


[3] Need for establishment of kindergarten schools in every ward/ village for every 2 km in urban areas and every 3 km in rural areas

[4] Distance to educational institutes from home according to age of students;  less than 5 km for up to 5th standard, up to 7 km from 6th to 10 , for 10+2/11, 12th the maximum distance is 10 km for saving time, health, better education and to reduce pollution levels/ carbon emission and many other benefits.


[5] Mandatory all educational institutions should have website with all information in standard format with clear approvals for running the educational institute, the approvals for building plan, amenities, faculty, fees etc for scrutiny by the prospective parents and others 


[6] The number of students in a class room should not be more than 30; but number of sections of same class can be many. 

[7] Mandatory all educational institutions (government & private) must provide reservation as per percentage of population of caste, religion, gender), in addition as per income group in the government educational institutions 


[8] Mandatory hence forth to remove caste names in the general name register and educational institute records 

[9] The teacher should not have more than 4 classes per day with no back to back classes (a gap of on period/45 min required between each period) for better deliver the subject 

[10] Autonomous body to decide the content in subjects for various classes, also for introducing new innovative simple & effective ways of teaching techniques in education system

[11] Change in education curriculum for all students from kg to degree  introducing social education for practical knowledge in education to ensure the students aware of life, society etc in addition to regular education with weightage marks of 70% for regular education and 30% for social education

[12] Mandatory uniform syllabus for 10+2 schooling for all state intermediate course to enable all students to choice what they would like to go for in degree, either arts, engineering, medicine etc.

[13] Mandatory uniform working hours in all educational institutions with different timings as per the sun rise and sun set.

[14] Mandatory coordination committee among teachers of all subjects in every class for providing appropriate home work ensuring home work of all subjects do not exceed 2 hours of study at home; mandatory weekly plan for each class, to be up loaded in website and also inform to parents through e mail, SMS, daily plan of subjects/chapters for next day.

[15] All students must be thought & all parents must ensure that their children (students) follow standard daily timetable in daily life for effective & efficient use of time (time management) for success in education & in life. 

[16] Mandatory all students must maintain a daily dairy from 5th standard onwards to inculcate discipline in them from childhood to follow time management and to be truthful  

[17] Mandatory large screens/ flat television sets with internet & intranet in all class rooms in all educational institutions for regular education & social education


[18] Measures for identification of talent /interest in the child from childhood of three years age and encouraging child in that field as child prodigies 

[19] Choice of different combinations of subjects of interest  by students from  degree on wards  


[20] Measures to reduce weight of school bags  

[21] Digital text books by the government education department; free access to digital library 

[22] Mandatory use of GPRS enabled school/ collage bags to be carried by all students for identifying the location of students to a great extent. Mandatory bio metric attendance in all educational institutions for students & teachers.


[23] Mandatory teaching of constitutional rights, protection; what is corruption, how to identify corrupt people act, how to prevent corruption as part of school curriculum 

[24] Teaching of social obligations on every students; all students & teachers must mandatorily participate one day in a month on community service as part of educational curriculum. 

[25] Mandatory martial arts for all students for both school and collage children and regular practice for self defence 

[26] Mandatory for all students to choose one of the arts either Indian traditional dance or Indian traditional music or Indian traditional arts of that territory and get trained in that discipline.

[27] Mandatory all educational institutions must conduct the lectures of persons belong to various sections/professions like farmers, cobblers, traders, etc their stories of success to provide inspiration to students.

[28] Mandatory all the students from 10th onwards be thought about disaster management, rescue & relief work, and community policing; this training mandatory for educated / un educated to get employment.  

[29] Mandatory puzzles, mind games, cross words etc should be thought to students from kg to 7th standard for development of their analytical thinking, memory power.  

All students from 4th standard to 9th standard must be thought of using abacus (mental arithmetic).

All students from 7th onwards the power of sub conscious mind

Also all the students from 10th class till pg should be thought about the body language for boosting self confidence and understanding others better.  

[30] Mandatory current affairs teaching in every educational institute in addition to teaching of general knowledge 

[31] Mandatory group discussions from class 7th onwards once in a month at the educational institute;  mandatory quiz in the class every month months on the subjects they studied in the last months

[32] Mandatory course for patriotism with greatness of Indian-ness as its theme to all students.


[33] Standard uniform for all educational institutions from kg to pg; white top, brown/khaki bottom with white scarf/ optional astrology scarf’s on week days.

[34] Mandatory that all educational institutions must supply uniform rain coat, uniform sweater and bucket hats to protect from rain, cold and hot sun during summer to protect students from seasonal health disorders; in addition solar lamps for all students 

[35] Mandatory ban on students wearing shots, miniskirts etc in the educational institute campuses /hostels 

[36] Mandatory appropriate uniform hair cut for all students according to the gender

[37] Mandatory regulating/restricting wearing, jewellery in educational institutions, bringing gadgets as education does not require luxury accessories  

[38] Mandatory every class room has a wall clock; same wall clock should be provided to students to keep at home study place. 


[39] Complete ban on use of personal vehicles (except bicycles) in all educational institutes; all educational institutions must have mass transport vehicles for use by students & staff. 

[40] Mandatory speed governors for the vehicles carrying the students, also speed restrictions in the educational institute premises of 500 meters radius.

[41] Mandatory students get training in bicycle riding from 5th standard onwards as part of educational curriculum; also government must construct multi level vertical bicycle parking centres in every 5 km distance in the city in the vicinity of the educational institutions/ office establishments.

[42] Also government must make it mandatory learning of motored two wheeler for all students  by age 18 and by age 21 the four wheeler driving as a part of education curriculum; government must establish motor vehicle driving schools (two wheelers, four wheelers), in every Mandal/block and in every district heavy vehicle driving licence.

[43] Levy of environmental pollution tax for using personal vehicles for all employees of any organisation for travelling more than a fixed distance.


[44] Mandatory teaching about healthy food habits, about food adulteration prevention, about need for hygienic and healthy foods, about why one should avoid regular consumption of junk foods  in audio visuals & in printed booklets as part of school education curriculum 

[45] Mandatory all educational institutions provide lunch in the premises for all day scholar students & staff; all hostels should be provided with  breakfast, lunch, evening snacks, dinner; in addition  all educational institutions must provide reverse osmosis filtered water.      

[46] Mandatory responsibility of the teachers for hygienic surroundings and quality food served in educational institutions and hostels

[47] Nutritious food for students; nutritionist in every educational institute canteen/ kitchen 

[48] Marks for fitness and sports; sports facilities in every ward, village 

[49] Need for inculcation of vegetarian food habits in students, all educational institutions must serve only vegetarian food for all day scholars, for non vegetarian hostel student’s weekly once non vegetarian food. 

[50] Need for complete ban of import of packed raw non vegetarian from abroad to save youth especially the students from health disorders due to consumption of such non vegetarian fast foods; ban on sale / use of frozen non vegetarian; ban on use of caged eggs/chicken. 

[51] Mandatory family lunch/ dinner at least once in a week every week

[52] Quality nutritious balanced diet for students from downtrodden sections in welfare hostels & at their home


[53] Mandatory basic health education for students

[54] Special classes for all girls from 6th standard onwards regarding female related health issues; also for all mothers of students, all ASHA’s & all SHG women  

[55] Mandatory health check up in all educational institutions for all students ; maintenance of health records by the educational institutions 

[56] Mandatory hence forth all births / delivery of pregnant women must take place in hospitals 

[57] Mandatory hence forth all hospitals, parents must preserve the stem cells (blood present in the umbilical cord which is the link between mother and baby after delivery of baby) of the new born child, government make it free storage 

[58] Mandatory hence forth that all the government or private hospitals or doctors should treat the patents in emergency especially the children/ students in the vicinity of stay of the patents/ child/ student; a criminal non bail able offence for denying treatment in emergencies


[59] Mandatory that students should maintain inventory of their belongings; to inculcate discipline & responsibility, about value of money. 

[60] Mandatory parents of hostel students and hostel students jointly declare inventory of the items they are brining into the hostel. 


[61] Mandatory that out station students should stay in hostel, or in blood related family members place, complete ban on students staying in friends place, or taking separate room and staying; government construct public hostels in every Mandal for outstation students;  government ban on providing premises on rental for students, in residential colonies & in commercial establishments.

[62] Mandatory hence forth all the hostel facility should be dormitory with complete ban of individual rooms for students in hostels to contain happening of watching pornography, tobacco smoking, alcohol consumption, drugs consumption, masturbation, gay, lesbian activities in the hostel rooms.

[63] Government ban doing more than one degree/post graduation/ doctorate staying in the hostels; no restriction on number of degree/pg’s/doctorates any individual wish to do in his/her life time;  no hostel facility for those who are suspended from education, also for those who fail to complete the course in time beyond one year grace period.


[64] Measures to contain  drug addiction, tobacco consumption / smoking, pornography, prostitution, live in relationship, complete ban on so called love for students, pre matrimonial sex, adultery, prostitution in educational institutions 

[65] Mandatory installation of smoke detectors, breath analysers,  in all educational institutions and in  hostel premises; tests done under camera recordings, live/recorded web caste to parents 

[66] Complete ban on sale of alcoholic beverages to students/ aged below 25 years;  measures to contain  sale of alcohol to under aged 

[67] Mandatory government ban the “pan shops” in the vicinity of educational institutions, especially the hostels, complete ban of sale of loose /single cigarettes

[68] Need for government surveillance on addictive martial, social media use of individuals to contain addictions, prostitution

[69] Also government must establish drug de-addiction, smoking de-addiction, alcohol de-addiction centres in very block in the country 

[70] Complete ban of so called disco bars, loud music/ dim lights in any bar & restaurant or even coffee shops, mandatory every nook and corner should have sufficient light and compete ban of partitions/ opaque areas, in addition entire premises must be under high resolution cc camera survive lance, and all entry on bio metric AADHAAR card linked, all payments only through bank cards or mobile wallet, complete ban on cash sales; mandatory to reveal the details of ingredients of the drink/ food served in the bill. 

[71] Complete ban of so called parties in the educational institutions, only tea/snacks should be served only in day time pre lunch or after lunch on any occasion.

[72] Banning birthday parties/ celebrations in educational institutions

[73] Need for monitoring of foreign students to contain drug peddling in educational institute premises 


[74] Mandatory in all educational institutions that female students tie Rakhi’s to co male students of the same class/section; mandatory sale of pregnancy test kits on providing marriage registration number / live in relation registration number. 

[75] Measures to reduce happenings of child sexual abuse by the paedophiles, pre matrimonial sex, and adultery by students / on students outside educational institutions.

[76] Special cells in every educational institutes for handling sexual harassment; without fir circulating in social media by the victim or by the media (print & electronic) for media/social media trail without any legal trail, should be a non bail able crime for attempting to tarnish the image of accused before the courts award conviction.


[77] Government must amend constitution to provide more  punishments than punishment normal under IPC for  atrocities / crimes against students, for spoiling their entire future as the budding minds will be under unknown stress for rest of their life for the crimes against them  

[78] Government must establish special trail courts for matters related to students and crimes done by, against students; special prisons for students for ensuing these budding minds are not mixed with hard core criminals  


[79] Government must ban all national and international events of sports, culture, film etc during examination  period; complete ban on strikes/ agitations/ protests during examination period; government must make it mandatory that all examinations from 7th standard to degree including all competitive entrance examinations should be held between  Feb 15th to 15th April 

[80] Ban on using students to greet elected representatives, doing formations during national functions. 

[81] Complete ban on using students as visitors/ audience in any entertainment programmes in the television programmes; students can attended only current affairs debates/discussions/ quiz programmes as participants with permission of the educational institute.

[82] Ban on giving educational institutions premises for any functions/ programmes of government/ political parties/ any private function.

[83] Complete ban of loud music in the residential habitations and no kind of public programmes with loud music organised in mohallas, wards, villages or residential apartments / gated communities / colonies or religious places like temple, masjid's on all 365 days. 

[84] Complete ban of film based songs, dances during any events conducted in the educational institute premises or in any competitions / functions among the students, or where the students are present in that event.


[85] Mandatory display of all religious secular symbols in every educational institution.

[86] Mandatory performing prayer & yoga/ mudras daily in educational institutes/hostels; making breathing related spiritual techniques like “Maha Medha Kriya” as part of education curriculum from KG to PG students daily activity before beginning of classes for the day

[87] Mandatory that all educational institutions must celebrate all religious festivals

[88] Mandatory that religious subject in educational curriculum from class 5 onwards  

[89] Bhagavad Gita must be thought in every educational institute as a part of educational curriculum from kg to pg for imparting leadership principles to lead a perfect life in righteous manner.

[90] Complete ban on taking religious deekshas (all religions) wearing religious specific dress/ following religious rituals during the working days / functioning of the educational institute by the students and staff (teaching & non teaching)

[91] Also need for establishment of Veda schools in every Mandal in the country where the Hindu population is more than 50% of the total population of that Mandal; also establishment of religious universities covering all religions in the country for providing higher religious education as well as research in religious history, education, etc ; also establishment of Sanskrit & Veda schools in every foreign country  

[92] Mandatory that each family (having children studying from kg to pg) should raise a cow

[93] Incentives for rising pet dog by students of 7 + in their home to reduce their stress to a great extent.


[94] Mandatory educational institutes conduct parent’s pada pooja festival. 

[95] Mandatory inculcation of respect towards elders, aged people especially the grandparents in the family; mandatory grandparents day in educational institute till from kg to 10th standard; mandatory that the students must visit their native place or a village


[96] Mandatory all students possess bank account all payments made for the students by parents, by the students should be through student bank account only; also government open mandatory bank account for all new born child hence forth with minimum deposit from government.

[97] Mandatory joint bank account of the educational institute with government educational department for ensuring educational institutions fees collection, spending etc can be monitored directly; all payments received from the students should be through bank transition only; complete ban of payments in cash.

[98] Need for regulation of capitation fee in professional courses; measures to contain black money circulation in education sector 

[99] Government must ban use of air conditions in class rooms, air condition buses etc by the educational institutions.

[100] Incentives for individuals and corporate for adopting schools/ educational institutions either personally or in-group 


[101] Mandatory that all students declare their mobile phone numbers, internet broad band connections details, their social id, devices / equipments like mobile computers etc   

[102] Mandatory restriction on use of mobile phones in the premises of educational institutions; data of usage of mobile phones with contact details, duration of call, number of texts etc should be shared with parents of students below 21 years for ensuring parents monitor their child’s activity.

[103] Government must regulate social media use in India to ensure the social media service providers make sure that all under aged (below 18 or 21 years) should automatically be shared a carbon copy with parents and teachers account.

[104] Regulating use of spy cameras, cc cameras, all users must use only on approval from government, government must maintain data bank of all those who possess spy cameras, cc TV cameras, it should be criminal offence to use spy camera/ mobile cc camera for recordings (voice/video); also criminal offence to share/exhibit in private/ public (social media/ media) by private individuals, organisations. Also such un authorised recorded films are not admissible under court of law. 

[105] Mandatory entry to cinema halls only through bio metric entry to prevent students bunking classes and visiting cinema halls 


[106] Banning student unions & elections; mandatory students committees (in place of class leader & students union); banning political affiliations of students committees; banning strikes by students


[107] Mandatory establishment of parents committees in educational institutions  

[108] Mandatory on the part of classmates/ roommates students to report if any student /teacher/staff indulging in unlawful activity; wilful concealment of facts should lead to punishment 


[109] Mandatory that every student must clean the class room once in a month with broom and dusting to induce self service, equality in them; all students must be thought of cleaning the bath rooms by assisting the toilet cleaning staff/sweepers twice in a year for inducing in them dignity of labour do itself at home.  

[110] Mandatory that students / parents of the students must make their home premises clean, neat and clutter free, and marks for clean homes.

[111] Mandatory hygienic environment in the premises of educational institutions, also within 500 meters radius of educational institutions; mandatory planting of mosquito repellent plants in the compound of educational institutions 

[112] Mandatory that common washing machine facility in all hostels for ease of students washing the cloths. 

[113] Students should be made as brand ambassadors for sustained positive change in all sections of people for better living habitations and inclusive growth    

[114] Mandatory girl friendly toilets attached with separate room for changing sanitary napkin pads. 

[115] Total out sourcing/privatisation of maintenance of toilets & kitchens in the educational institutions for clean & hygienic atmosphere and better delivery of services. 

[116] Educational institute must post daily online the hygienic measures taken to ensure educational institute is clean


[117] Mandatory that educational institutions must conduct training for parents on students up brining; also mandatory psychological training for parents, students for ensuring children do not behave abnormally like jealousy, hate etc, how to induce compassion, love, etc.

[118] Mandatory periodic interaction of teachers with parents for updating on education, health care of each and every student; mandatory student- parent- teacher- hostel care taker/ warden interaction either personally or via face time/ video conference call.


[119] Autonomous body for teachers recruitment for government & private educational institutions, uniform working time,  pay, terms for all teachers in government & private educational institutions; mandatory proportionate representation of castes, religion, gender in all educational institutes in teaching and non teaching staff.    

[120] Training to all teachers in simple and easy understandable methods & techniques of teaching 

[121] Teacher’s skills/ability linked to salary, school fee (in case of private schools) for better performance of teachers & better education of students; performance of the students is the basic parameter for testing the ability of the teacher.

[122] Rewards for innovative methods of teaching which are easy, simple, cost effective developed either by the educational institutes or individuals.  

[123] Government must provide infrastructure & establish teachers training institute in every Mandal/block for training the teachers, upgrading the teacher’s skills every three years. 

[124] Teacher’s recruitment only from local candidates for better delivery of subject in local language/ local dialect. 

[125] Autonomous body for promotion, transfers matters 

[126] Complete ban of films showing teachers as comedy persons or students teasing teachers, or so called love among the female and male students / student teacher love etc 

[127] Mandatory to conduct teachers day as guru pooja utshav by performing pooja in a traditional way and mandatory adoption of students as disciple/ follower by teachers in a traditional manner according various religious dharmas


[128] Mandatory all the educational institutions buildings are vastu compliance by and large for ensuring natural ventilation, free circulation of air and in line with geo magnetic forces of nature for ensuring perfect mental stability and good education. Also mandatory green buildings with maximum use of alternative energy 

[129] Mandatory covered auditoriums in every educational institute  

[130] Mandatory white wash and paintings in every educational institute every academic year, also change of bed and bed Lenin for every student in hostel for ensuring fresh new looks, which has impact on the students concentration to a great extent 

[131] Low cost ready to build material for schools, to reduce infrastructure costs, alternative building material, and less wood in buildings to conserve the forests

[132] Mandatory employment of qualified electrician & qualified plumber in all educational institutions having more than 1000 children in a single campus seating capacity

[133] Mandatory that all educational institutions must be inspected by a government department of roads and buildings to inspect all the educational institutions for the safety of the buildings, the electrical connections, the plumbing connections, seepages, cracks etc etc every six months and make the records public online.



[134] Community study centres in each ward/village/ slum to be centres for study for the downtrodden children, also centres to share their knowledge, exclusively only for students.  

[135] Mandatory to ensure standard of living in the government welfare hostels maintained with standard quality building, bedding, hygienic toilets, and surroundings for better education of downtrodden section students.

[136] Mandatory responsibility of the elected representatives to adopt the government school & government welfare hostel in their territory during their tenure  for “ADARSH VIDYALAYA”  like same spirit of “adarsh gram”; 

[137] Incentives for converting  used / old mass transport vehicles as mobile education units 


[138] Mandatory greenery in every educational institute, hostel, a garden full of medicinal value plants like Tulsi, neem, eucalyptus plants surrounding the compound, in addition there should be indoor air purifier plants in every class room which provides fresh air by sucking pollutant gases within the class room. 

[139] Mandatory every student raises one plant every year and take care of the plant; mandatory student must raise one tulsi (basel) plant in their home from class one onwards (irrespective of religion they should rise), marks for raising the tulsi plant in their home.  

[140] Water conservation methods in educational institutions; mandatory use of recycling waste water to use for toilet flush.


[141] Mandatory all examinations should be under cc camera with bio metric entry, admission card linked to AADHAAR card.  

[142] Measures for accurate correction, tabulation  of written answer sheets  

[143] Evaluation of  answer sheets from class 7th onwards by random selection of other educational institutions teachers


[144] Mandatory attendance of  80% over all is required to appear for examinations; cumulative marks from the quarterly examinations for arriving final marks 

[145] Mandatory detention of students from 7th standard onwards for ensuring fundamentals of education are strong for brighter future; mandatory re examination before detention 

[146] Mandatory declaration of examination results within 15 days of last examination. 

[147] Ban on coaching classes during the running of academic year for all students; coaching centres can run coaching class for those students who completed the academic tenure of that level of education.  

[148] Ban on educational institutions, coaching centers or any individuals from advertising in media, social media about the annual academic achievements of their students like our institute got 1st rank, got 50 ranks in top 100 etc to woo students, however they can claim with proof in their designated website. 

[149] Government must ban private tuitions to the students by the teaching staff of educational institutes (whether government and private) and conducting, attending such private classes should be a criminal offence; also regulation of private tuitions by the qualified teachers who are un employed, only under the advice of the educational institute for special additional teachings requirement for the students; with mandatory government registration for private teaching under strict regulations  to ensure students are not subjected to over stress/abuse.  

[150] Government providing national toll free number for providing counselling / assistance for students in distress 


[151] It should be a serious criminal offence to do canning/ beating or abusing students by the parents or teachers, total ban of corporal punishments, only persuasion 

[152] Parents consuming alcohol, smoking/ drugs in the home, in front of children/ students &nbs
          Beverley from South Africa        
beverleyThe story of Steven, and the legacy of Steven that is now coming to be, for 2018.  Thank you to Beverley for recognizing the need to help the less fortunate children and helping them get the basic healthcare all children surely deserve.  The motto of this year’s marathon is… It Moves you…  And stories like […]

End of healthcare boom?!?
Ruining public health services is no solution to solve healthcare prob
India's healthcare industry is growing at a rapid pace, with a growth rate of 12 per cent '' driven by higher life expectancy and income, along with transforming demographics, and arrival of life-style diseases vis-'-vis chronic ones! The healthcare market in India is expected to touch $70 billion in 2012 from being half of that in 2007. Mckinsey has approximated a figure of 315 million to be insured by the end of 2010 across the country, which otherwise would have to bear the grubby and sordid environment and substandard facilities of government health centers. No wonder there are one million casualties from curable diseases every year, with very little admittance to specialists, especially in the rural areas as 80 per cent of them have clamored in the cities. Only 400 million in our country can reach specialists portrays a very gloomy picture, leading to deaths or aggravation of diseases for the unfortunate rests. Not only specialists, there are shortages at every level in government hospitals with 24 per cent admitted are below poverty line. The expenditure on health is 4.9 per cent, of which government spends a meager 0.9 per cent with rest 4 per cent being private expenditure. The states involvement in providing standard medical facilities to its masses is even worse ' as a percentage of budgetary allocation its investment has fallen from 7 per cent in 1990 to 5.5 per cent at present. Consequently, India's availability of hospital beds is abysmally low, when the global average is 3.6 beds per 1000, India has shamefully 0.7 beds.

The government, since the last few decades has systematically broken the backbone of public sector healthcare facilities leading to mushrooming of private sector units. There is a comprehensive failure of our government in providing access to basic healthcare of our people. Out of 11,25,000 medical practitioners, only 1,25,000 are involved in public sector units. The urban rural divide is lopsided as well. The cities constitute 59 per cent of all health practitioners although majority of our population live in rural areas. 60 per cent of all doctors in Maharashtra live in Mumbai which comprises only 11 per cent of the state population. Having said government's apathy towards improving health facilities in rural areas, in 2009-10 annual budgets however it has announced an increase of Rs.40 billion.

Behind the glitzy settings of private sector demand for monetary splurge, through avoidable diagnostic treatments, surgeries and other unethical practices has made the patients staggering for fund. Almost all developed nations have an organized health system, with government contribution of 60 per cent to 100 per cent ' with only exception of the United States ' whose treaded path we are following. Before we sum it up, it must be noted that high-end private hospitals, who were charging exorbitantly from the patients blessed with cashless mediclaim; can no longer do it as private sector as well as public sector insurance companies have denied this facility in select cities (it will extended soon in other cities as well) marking the end of a 'healthcare boom' phase. We should not be following American example as 30 million of it's own population is refuted of any kind of medical insurance, with have and have-not gap is widest and ever increasing!

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          AIDS 2010: A Final Look        

I knew AIDS2010 in Vienna would be a great learning experience, but I suppose I didn't expect to feel such profound gratitude for my life and my advantages. Life is such an arbitrary thing; I was born here, you were born there, she was born over there... and that simple geography equation will mean virtually everything when it comes to our human rights, our access to basic health care and services, and how long we will likely live on this planet.

          Why I Am A Liberal        
Well, friends, I am starting to string some sentences together to start working on my next book, which will be called "Now, What's Left?"

The first thing I have to do is put together a book proposal, which is kind of a big job, but - the good news is that when it's done, you've really done the hardest part of writing the book.

So, in preparation for the proposal, I'm sort of synopsizing everything that's been rattling around in my head that I want to be a part of this book, and one of the things I ended up doing was making a list of the reasons I am a liberal.

I'm sure I'll think of more, but... here goes!

This is what being a liberal means to me:
·      I believe that freedom means freedom for everyone, not just me and mine;
·      I believe in not only personal responsibility but shared responsibility towards the group of which I am a part;
·      I believe that leadership does not equal dominance
·      I believe that every person is entitled to dignity and respect, not because of what they have but because of who they are – human. I do not believe that someone who has more than I do is more worthy than I am, and I do not believe that someone who has less than I do is less worthy.
·      I believe that each individual’s religious belief (or non-belief) should be respected, but it should not infringe upon others’ belief, non-belief, or personal freedom and that religion and government should be separate – for the good of both.
·      I believe that the qualities of tolerance and empathy are not the same as ‘moral relativity’ (whatever that actually means), but are expressions of the Golden Rule and moral values to which I am proud to aspire.
·      When people disparage ‘diversity’ (always said with the little eye-roll), I assume they prefer inbreeding.
·      I believe that there are some things that government is better equipped to deal with than private enterprise; that there is room for both. I do not believe government should be run like a business, and I do not believe that private enterprise should be run like the government.
·      I believe that the areas that include shared life-and-death resources (clean air, fresh water, safe food, transportation infrastructure, judicial and legal infrastructure, essential [not elective] medical care, military defense), and education for all, should be administered, overseen, and protected without a profit motive by a body that is accountable to the people – that is, government.
·      I respect tradition, but not for tradition’s sake only; I embrace change, but not change for change’s sake. For each I ask myself, “Is it necessary?”
·      If I claim freedom for myself, I need to extend it to others in return. Civil rights are rights conferred upon citizens, and civil marriage is one of those rights. No one should be guaranteed a religious marriage; that is up to the tenets of that particular religion and not the business of government. But civil marriage recognized by the state grants rights, benefits and responsibilities to married couples that all citizens who wish to marry the person they love should be able to benefit from – and be responsible for.
·      I believe basic health care is a right, and not only that, but a benefit to society that saves money to all Americans in the long run. I believe that national single payer health care, administered (but not provided) by the government, is the most cost-effective and fair way to ensure that no person is denied care because they can’t afford it, or goes bankrupt because of an illness or accident.
The argument that health care should not be called a ‘right’ because no doctor shoud be forced to care for an ill person against their will makes no sense. Emergency rooms are already mandated to care for anyone who comes in regardless of their ability to pay; the cost is astronomical and borne by the taxpayers anyway.
No one should die because they can’t afford care, and if the costs of medical care are shared in a large enough pool that includes healthy people as well as sick people, then medical costs will be more affordale all round. This is nothing more than insurance, taken to its logical conclusion – but without the profit motive that takes precious dollars away from health care. No other industrialized nation allows insurance for profit; even private insurance is non-profit. It is immoral to me to enrich myself at the cost of human health and life. Not only that but it is a drain and an expense that society must pay for in terms of lost productivity, lost wages, families thrown into poverty (and the public dole) – so it is actually cheaper and more efficient on many, many levels for society to manage health care.
If I wish to have a 5-star hotel-room hospital experience, or get elective plastic surgery to indulge my vanity – by all means, let the market take care of that! If you want it and can afford it and an insurer wants to make a profit from that, go for it.
Private, for-profit insurance for things like cars, houses, travel, flood, hurricane, fire and other things that you choose to have in your life that cost a lot to replace is perfectly useful as far as I’m concerned, but in matters of a human life it is unconscionable.
·      I believe that government is US – We the People – and, as flawed as it can be, it is answerable to us. Private enterprise in charge of public needs is NOT answerable to us (See California’s disastrous power deregulation and susequent grotesque theft from the people of CA for a good example of what the lure of the profit motive can lead to with public utilities.) Privatization is not the answer to what’s wrong with government.
·      I do not believe that the Invisible Hand of the Free Market will make everything hunky-dory with the economy. I think that is a willful misinterpretation from Adam Smith that Republicans accept as fact because it favors the interests of Big Business to do so. I do not believe that ‘free markets’ are free if all the power is on one side of the equation.
·      I do not believe that tax cuts for the wealthy create jobs. All they do is add to the deficit and give Republicans an excuse to cut social programs in the name of ‘deficit reduction’.
·      I do not believe you can ‘cut’ your way out of a depression (pardon me – a recession.) by belt-tightening. Just ask Hoover – or go visit a Hooverville. I hear they’re quite the ‘coming thing’.
·      I believe that workers have the right to organize and negotiate with the companies they work for. Otherwise, it becomes a race to the bottom for the cheapest labor – leading to the demise of American jobs, massive outsourcing and the demand for, not just immigrant labor, but illegal immigrant labor (basically slave labor) – as a business model! Union wages keep non-union wages high as well, leading to a strong economy where there are consumers who can afford to buy things that cost a little more. It’s a race to the top instead of the bottom.
·      I also believe in reasonable regulation. If we had had reasonable regulation in place over the last 15 years, we would not be in an economic collapse only rivalled in the last century by the Great Depression. There is a middle ground between micro-managing and reasonable regulation, but the corporate powers-that-be treat any attempt to oversee financial matters as the grossest of meddling, nit-picking, and job-killing. That, of course, is their strategy. It’s called ‘working the refs’ and it has worked like a charm for them. For us? Not so much. Even a football game has rules.
·      I believe that justice and the rule of law should not be for sale to the highest bidder.
·      I believe that elections should be financed by the public to ensure that politicians are not purchased by corporations and that the important work of our nation is not disrupted by 24/7 fundraising once a candidate is elected. I don’t believe a congressperson should be under the thumb of corporate money, and subject to the pressure of having an opponent financed by a corporation if that congressperson doesn’t ‘play ball’. I also do not believe that there should be a revolving door between Congress and K Street once that Congressperson leaves office.
·      I believe we overlook conflicts of interest at our peril.
·      I do not believe that military dominance of the world is the way to keep America safe.
·      I do not believe that we should ever pre-emptively attack another nation, and that war should be the last of last resorts in self-defense. Real last resort, not pretend, made-up ‘last resort’ that was actually the first resort. I wish there was no reason for war at all, but if we do go into combat, we should take care of our soldiers both in and out of the service, for as long as they need it. It is the least we can do for the men and women of whom we have asked the unspeakable. David Swanson is right; war is a crime. I wish I were smart enough to figure out how to keep our governments from engaging in them.

Well, it's a start...
          Improving the Affordability of Coverage through the Basic Health Program in Minnesota and New York        
To date, Minnesota and New York are the only states to have adopted a Basic Health Program (BHP), an option in the Affordable Care Act (ACA) that permits state-administered coverage in lieu of marketplace coverage for those with incomes below 200% of the federal poverty level (FPL) who would otherwise qualify for marketplace subsidies. BHP covers adults with incomes between 138-200% of FPL and lawfully present non-citizens with incomes below 138% FPL whose immigration status makes them ineligible for Medicaid. This brief reviews Minnesota’s and New York’s approaches to BHP and assesses BHP’s impact on consumers, marketplaces, and state costs. Although there is uncertainty around the future of the ACA (including BHP) following the 2016 election, BHP implementation offers important lessons for consideration in future reforms about structuring coverage programs for low-income uninsured consumers.
          Comment on 261, Basic Health Tips – Dr James Marcum by Health Tips        
What a nice post. All the tips are really good and helpful . Thanks Dr James Marcum for your post.
          Too many Afghan women in London face racism, sexism – and unwanted pregnancies        

Recent research on Afghan immigrant women in London has revealed a multi-layered crisis. What can be done to address this, and to empower them?

Houses in north London. Houses in north London. Photo: Andrew Parsons/PA Images. All rights reserved.Afghan immigrant women in London seem to be suffering from a slow and hidden epidemic of unwanted pregnancies. The government has failed to give an exact picture of what is happening on the ground. However, at South Asian Sexual Health (SASH) we have conducted research that suggests a lack of awareness about sexual health is endemic among first generation immigrant families.

We interviewed more than 40 Afghans (women and men) in four boroughs of west and north-east London. Their testimonies reflected how racism and sexism have combined to produce numerous unintended pregnancies. Women are being denied basic human rights by male members of their families and the British government must do more to help them and address the sexual health burden they carry.

‘Shockingly, moving to Britain seems to have done little to help Afghan women transform their lives’

Afghanistan has been described as one of the most dangerous countries in the world to be a woman. In the UK, the diaspora has grown significantly since 1997 when the Islamic fundamentalist Taliban seized control of the country. Under their rule, women were kept as caged birds deprived of basic human rights such as access to education and the right to marry who they chose.

Shockingly, moving to Britain seems to have done little to help Afghan women transform their lives. Twelve of the 20 women we interviewed were married, and most of these married women were unemployed – but not because of a lack of qualifications. Most were university graduates, including doctors. But they weren’t â€œallowed to go outside,” as several respondents put it.  

Recruiting Afghan women to participate in research like this is extremely difficult as they often live in secluded communities that are hard for researchers to reach, in part because of language issues. Our in-depth discussions – in Dari and Pashtu – were intimate and emotional.

Rabia*, 41 and a mother of four, was a medical doctor in Afghanistan. She moved to London 17 years ago to live with her husband. She expressed little or no control over her sexuality. Rather, her testimony reflected how her body is bound by cultural assumptions that women’s duty is to submit to men’s demands. She said, for example, that she “never wanted to wear Hijab” but that her “husband gets upset” when she doesn’t.

“I'm not allowed to go out without my husband’s permission”

Nasrin*, 32, had an arranged married with a 43 year old Afghan man when she was 17. Her husband sought asylum in the UK after 9/11, after which she joined him. “I suffer from constant depression,” she told us. “I am not allowed to go out without my husband’s permission. If I do, he doesn’t talk to me and throws food. He sometimes hits me. I have four kids. I am busy cooking and cleaning. Afghan culture is like that”.

Women we interviewed described issues of culture, religion and gender as key barriers to accessing sexual health services as well as public places in general. They expressed finding it difficult to be part of broader social life because they can’t engage with mainstream society – as if their lives were hermetically-sealed, guarded by virtual, community fences.  

East London is home to many South Asian communities including members of the Afghan diaspora. East London is home to many South Asian communities including members of the Afghan diaspora. Photo: Ritu Mahendru. These women also revealed that they don't associate sex with female pleasure – and that they often unwillingly bear the consequences of unprotected sex.

For Rabia, an inability to negotiate safe sex with her husband led to unintended pregnancies. She said: “Sometimes I don’t feel like having sex but he tells me that I am an educated woman and I should know that men have more sexual desires than women. Sometimes he doesn’t even care if the children are sleeping next to us”.

Knowledge of contraception is also shaped by myths and lack of trust in modern methods. One woman said pills are “not good for [one’s] health”. Another claimed: “I am breastfeeding and most pills aren't compatible”. A third woman said, similarly: “I do not want to take pills. I have heard that they have side effects”.

Many of the women we interviewed said it is ultimately their husband’s decision which form of contraception is used. Several said that Afghan men prefer ‘traditional’ methods to prevent pregnancies, specifically ‘early withdrawal.’ This is concerning as 1 in 4 women will get pregnant if ‘early withdrawal’ is the only form of contraception used.

“It’s my husband’s decision,” said one woman who told us her husband had insisted she use an IUD even though she hated it. Nasrin said, about her husband: “There is a whole bag of condoms in the cupboard. He has never used them”.

“There's a whole bag of condoms in the cupboard. He's never used them”

Each of the women we spoke to said that while they should have the right to accept sex, they may not have the right to dissent. From my experience over the last seven years, working with Afghan women in South Asia and in the UK, including as an activist and with NGOs, this is not uncommon: refusing to have sex and displeasing your husband could lead to violence, and in some cases it could be seen ‘un-Islamic’ too.  

Some women said they had made joint decisions with their husbands to seek family planning advice. But even in these cases they said their GP appointments were almost always led by their husbands who acted as interpreters and had the final say.

One 34-year old woman, Samia*, complained of “a lack of interpretation services”. Nasrin said: “I know a lot of women… [for whom] their husbands do the translation. I am not sure if women are able to convey their sexual health problems to their GPs, out of fear, or out of being shy”.

All of the married women we interviewed complained that family planning programmes assumed that they were in charge, when in reality it is their husbands who govern their bodies and their choices.

‘The overall message is that no help is available’

The government’s integrated sexual health plan does not give any specific consideration to inequalities faced by minority women. Too much is left to the discretion of local NHS commissioners who are given no specific guidance on the needs of migrant women or how to monitor and address inequalities.

Rayah Feldman, at the charity Maternity Action, has also warned that women asylum-seekers and those with insecure immigration statuses are particularly impacted by ever-harsher discourse and legislation around their access to health care. Migrant women in the UK are currently required to pay 150% of routine tariffs for services if they haven't already paid a visa ‘health surcharge’.

South Asian clothes shop in London where Afghan women may buy traditional clothing. South Asian clothes shop in London where Afghan women may buy traditional clothing. Photo: Ritu Mahendru.The women we spoke to emphasised that they are unable to even leave their homes to access basic health services without their husbands. This exclusion is amplified by the British government which emboldens a hyper-masculine religious agenda, and allows Sharia courts to run in the UK, while rebuking refugees from the Muslim world in the mainstream media. The overall message is that no help is available.

Health service professionals are failing to respond to minority women’s specialist needs. Rights to privacy and informed consent are being undermined by gender and racial stereotypes. Although sexual health or genitourinary medicine (GUM) clinics exist, they are not necessarily a one-stop shop for all services. Most of the women we interviewed did not know how to access them.

‘To empower women, sexual health programmes need to be integrated with other services’

London is also home, however, to positive models of secular organisation fighting racial and gender equality. I have been active for example with the group Southall Black Sisters that has defended Black and minority women from harsh judgments and racism from the outside while remaining critical of fundamentalism and sexism within their communities.

As human rights defenders and activists, we can learn from examples like this to help address the multi-layered challenges faced by Afghan immigrant women in London too. A key lesson is this: To empower women, sexual health programmes need to be integrated with other services. They must be linked to efforts challenging the lower status of women, as well as religious fundamentalism, in the Afghan diaspora.

* Names have been changed to protect identities.

Country or region: 
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          Referring To All Natural Herbal Supplements         
There is no cure for that common cool. It is a sad fact that there is no way to end a chilly instantly through something or doing something. In fact, the particular pharmaceutical business has invested decades and also billions of bucks conducting research on finding a cure for the common chilly to no avail. With that said, there are many stuff that can be done to reduce the severity of the actual cold, decrease the amount of time that you are sick, and stop colds through showing up to begin with.

A lot of muscle-building supplements are available in the market. You have to carefully pick them. Choose the herbal products since they are harm less to the entire body and at the same time provide all the nutrients and minerals to maintain you active all day long. Include in your diet plenty of fruits and vegetables since they provide lot of fiber happy to the body. Consuming white meat like fish as opposed to the red meat are more beneficial for the. It is your obligation to make it a regular to spend time for the well-being of your body.

Modern medicine has been doing a great many points for health insurance happiness in the past 100 years. Polio has been cured, tiny pox has been eradicated, and many forms of cancer have got survival charges up above 80%. There have been a great number of medical progress; however, numerous natural remedies for basic health conditions have been just about forgotten through the vast majority of people. In years past, individuals would deal with many health conditions quite efficiently at home by utilizing natural remedies rather than racing off to the doctor to get a modern cure that is a lot more expensive as well as, often times, forget about effective than a natural 1.

Ginger is one of the most popular herbal plants and utilized in Asian food preparation to add a bit of aftertaste to the meals. It can also be cut into strips as a form of ginger herb dressing or perhaps added to plant and meat or broth dishes. At times, it is utilized to make teas and has been described as huge source of straightener, foliate, riboflavin and vitamins Any, B6, C, At the and Nited kingdom. Read more here Garlic is yet another common botanical herb used to perk up the taste on most cooked foods. It possesses a high amount of vitamin C and B6, vitamin Nited kingdom, thiamin, riboflavin, niacin calcium, in addition to different minerals.

A deficiency of some vitamins is actually dangerous as it can lead to serious illnesses. However, excessive use of vitamins is also bad for the body. It is, therefore, important to take the correct type and quantity of vitamins within consultation having a health consultant.

More health-mindful people have found herbal products more helpful because of the confidence that these normal medications feel at ease and better compared to the prescribed standard drugs. As a matter of fact, wellness fare created from herbs has been used by diverse civilizations within the last centuries.
          Neglected Indians & Public Policy in India        

by Amartya Sen

A fuller understanding of the real conditions of the mass of neglected Indians and what can be done to improve their lives through public policy should be a central issue in the politics of India.

The steadily rising rate of economic growth in India has recently been around 8 percent per year (it is expected to be 9 percent this year), and there is much speculation about whether and when India may catch up with and surpass China’s over 10 percent growth rate. Despite the evident excitement that this subject seems to cause in India and abroad, it is surely rather silly to be obsessed about India’s overtaking China in the rate of growth of GNP, while not comparing India with China in other respects, like education, basic health, or life expectancy. Economic growth can, of course, be enormously helpful in advancing living standards and in battling poverty. But there is little cause for taking the growth of GNP to be an end in itself, rather than seeing it as an important means for achieving things we value.

It could, however, be asked why this distinction should make much difference, since economic growth does enhance our ability to improve living standards. The central point to appreciate here is that while economic growth is important for enhancing living conditions, its reach and impact depend greatly on what we do with the increased income. The relation between economic growth and the advancement of living standards depends on many factors, including economic and social inequality and, no less importantly, on what the government does with the public revenue that is generated by economic growth.

Some statistics about China and India, drawn mainly from the World Bank and the United Nations, are relevant here. Life expectancy at birth in China is 73.5 years; in India it is 64.4 years. The infant mortality rate is fifty per thousand in India, compared with just seventeen in China; the mortality rate for children under five is sixty-six per thousand for Indians and nineteen for the Chinese; and the maternal mortality rate is 230 per 100,000 live births in India and thirty-eight in China. The mean years of schooling in India were estimated to be 4.4 years, compared with 7.5 years in China. China’s adult literacy rate is 94 percent, compared with India’s 74 percent according to the preliminary tables of the 2011 census.

As a result of India’s effort to improve the schooling of girls, its literacy rate for women between the ages of fifteen and twenty-four has clearly risen; but that rate is still not much above 80 percent, whereas in China it is 99 percent. One of the serious failures of India is that a very substantial proportion of Indian children are, to varying degrees, undernourished (depending on the criteria used, the proportion can come close to half of all children), compared with a very small proportion in China. Only 66 percent of Indian children are immunized with triple vaccine (diphtheria/ pertussis/tetanus), as opposed to 97 percent in China.

Comparing India with China according to such standards can be more useful for policy discussions in India than confining the comparison to GNP growth rates only. Those who are fearful that India’s growth performance would suffer if it paid more attention to “social objectives” such as education and health care should seriously consider that notwithstanding these “social” activities and achievements, China’s rate of GNP growth is still clearly higher than India’s.


Higher GNP has certainly helped China to reduce various indicators of poverty and deprivation, and to expand different features of the quality of life. There is every reason to want to encourage sustainable economic growth in India in order to improve living standards today and in the future (including taking care of the environment in which we live). Sustainable economic growth is a very good thing in a way that “growth mania” is not.

GNP per capita is, however, not invariably a good predictor of valuable features of our lives, for those features depend also on other things that we do — or fail to do. Compare India with Bangladesh. In income, India has a huge lead over Bangladesh, with a GNP per capita of $1,170, compared with $590 in Bangladesh, in comparable units of purchasing power. This difference has expanded rapidly because of India’s faster rate of recent economic growth, and that, of course, is a point in India’s favour. India’s substantially higher rank than Bangladesh in the UN Human Development Index (HDI) is largely due to this particular achievement. But we must ask how well India’s income advantage is reflected in other things that also matter. I fear the answer is: not well at all.

Life expectancy in Bangladesh is 66.9 years compared with India’s 64.4. The proportion of underweight children in Bangladesh (41.3 percent) is lower than in India (43.5), and its fertility rate (2.3) is also lower than India’s (2.7). Mean years of schooling amount to 4.8 years in Bangladesh compared with India’s 4.4 years. While India is ahead of Bangladesh in the male literacy rate for the age group between fifteen and twenty-four, the female rate in Bangladesh is higher than in India. Interestingly, the female literacy rate among young Bangladeshis is actually higher than the male rate, whereas young women still have substantially lower rates than young males in India. There is much evidence to suggest that Bangladesh’s current progress has a great deal to do with the role that liberated Bangladeshi women are beginning to play in the country.

What about health? The mortality rate of children under five is sixty-six per thousand in India compared with fifty-two in Bangladesh. In infant mortality, Bangladesh has a similar advantage: it is fifty per thousand in India and forty-one in Bangladesh. While 94 percent of Bangladeshi children are immunized with DPT vaccine, only 66 percent of Indian children are. In each of these respects, Bangladesh does better than India, despite having only half of India’s per capita income.

Of course, Bangladesh’s living conditions will benefit greatly from higher economic growth, particularly if the country uses it as a means of doing good things, rather than treating economic growth and high per capita income as ends in themselves. It is to the huge credit of Bangladesh that despite the adversity of low income it has been able to do so much so quickly; the imaginative activism of Bangladeshi NGOs (such as the Grameen Bank, the pioneering microcredit institution, and BRAC, a large-scale initiative aimed at removing poverty) as well as the committed public policies of the government have both contributed to the results. But higher income, including larger public resources, will obviously enhance Bangladesh’s ability to achieve better lives for its people.


One of the positive things about economic growth is that it generates public resources that the government can devote to its priorities. In fact, public resources very often grow faster than the GNP. The gross tax revenue, for example, of the government of India (corrected for price rise) is now more than four times what it was just twenty years ago, in 1990-1991. This is a substantially bigger jump than the price-corrected GNP.

Expenditure on what is somewhat misleadingly called the “social sector”— health, education, nutrition, etc. — has certainly gone up in India. And yet India is still well behind China in many of these fields. For example, government expenditure on health care in China is nearly five times that in India. China does, of course, have a larger population and a higher per capita income than India, but even in relative terms, while the Chinese government spends nearly 2 percent of GDP (1.9 percent) on health care, the proportion is only a little above one percent (1.1 percent) in India.

One result of the relatively low allocation of funds to public health care in India is that large numbers of poor people across the country rely on private doctors, many of whom have little medical training. Since health is also a typical example of “asymmetric information,” in which the patients may know very little about what the doctors (or “supposed doctors”) are giving them, even the possibility of fraud and deceit is very large. In a study conducted by the Pratichi Trust — a public interest trust I set up in 1999 — we found cases in which the ignorance of poor patients about their condition was exploited so as to make them pay for treatment they didn’t get. This is the result not only of shameful exploitation, but ultimately of the sheer unavailability of public health care in many parts of India. The benefit that we can expect to get from economic growth depends very much on how the public revenue generated by economic growth is expended.


When we consider the impact of economic growth on people’s lives, comparisons favour China over India. However, there are many fields in which a comparison between China and India is not related to economic growth in any obvious way. Most Indians are strongly appreciative of the democratic structure of the country, including its many political parties, systematic free elections, uncensored media, free speech, and the independent standing of the judiciary, among other characteristics of a lively democracy. Those Indians who are critical of serious flaws in these arrangements (and I am certainly one of them) can also take account of what India has already achieved in sustaining democracy, in contrast to many other countries, including China.

Not only is access to the Internet and world opinion uncensored and unrestricted in India, a multitude of media present widely different points of view, often very critical of the government in office. India has a larger circulation of newspapers each day than any other country in the world. And the newspapers reflect contrasting political perspectives. Economic growth has helped — and this has certainly been a substantial gain — to expand the availability of radios and televisions across the country, including in rural areas, which very often are shared among many users. There are at least 360 independent television stations (and many are being established right now, judging from the licences already issued) and their broadcasts reflect a remarkable variety of points of view. More than two hundred of these TV stations concentrate substantially or mainly on news, many of them around the clock. There is a sharp contrast here with the monolithic system of newscasting permitted by the state in China, with little variation of political perspectives on different channels.

Freedom of expression has its own value as a potentially important instrument for democratic politics, but also as something that people enjoy and treasure. Even the poorest parts of the population want to participate in social and political life, and in India they can do so. There is a contrast as well in the use of trial and punishment, including capital punishment. China often executes more people in a week than India has executed since independence in 1947. If our focus is on a comprehensive comparison of the quality of life in India and China, we have to look well beyond the traditional social indicators, and many of these comparisons are not to China’s advantage.

Could it be that India’s democratic system is somehow a barrier to using the benefits of economic growth in order to enhance health, education, and other social conditions? Clearly not, as I shall presently discuss. It is worth recalling that when India had a very low rate of economic growth, as was the case until the 1980s, a common argument was that democracy was hostile to fast economic growth. It was hard to convince those opposed to democracy that fast economic growth depends on an economic climate congenial to development rather than on fierce political control, and that a political system that protects democratic rights need not impede economic growth. That debate has now ended, not least because of the high economic growth rates of democratic India. We can now ask: How should we assess the alleged conflict between democracy and the use of the fruits of economic growth for social advancement?


What a democratic system achieves depends greatly on which social conditions become political issues. Some conditions become politically important issues quickly, such as the calamity of a famine (thus famines tend not to occur at all when there is a functioning democracy), while other problems — less spectacular and less immediate — provide a much harder challenge. It is much more difficult to use democratic politics to remedy undernourishment that is not extreme, or persistent gender inequality, or the absence of regular medical care for all. Success or failure here depends on the range and vigour of democratic practice. In recent years Indian democracy has made considerable progress in dealing with some of these conditions, such as gender inequality, lack of schools, and widespread undernourishment. Public protests, court decisions, and the use of the recently passed “Right to Information” Act have had telling effects. But India still has a long way to go in remedying these conditions.

In China, by contrast, the process of decision-making depends largely on decisions made by the top Party leaders, with relatively little democratic pressure from below. The Chinese leaders, despite their scepticism about the values of multiparty democracy and personal and political liberty, are strongly committed to eliminating poverty, undernourishment, illiteracy, and lack of health care; and this has greatly helped in China’s advancement. There is, however, a serious fragility in any authoritarian system of governance, since there is little recourse or remedy when the government leaders alter their goals or suppress their failures.

The reality of that danger revealed itself in a catastrophic form in the Chinese famine of 1959-1962, which killed more than 30 million people, when there was no public pressure against the regime’s policies, as would have arisen in a functioning democracy. Mistakes in policy continued for three years while tens of millions died. To take another example, the economic reforms of 1979 greatly improved the working and efficiency of Chinese agriculture and industry; but the Chinese government also eliminated, at the same time, the entitlement of all to public medical care (which was often administered through the communes). Most people were then required to buy their own health insurance, drastically reducing the proportion of the population with guaranteed health care.

In a functioning democracy an established right to social assistance could not have been so easily — and so swiftly — dropped. The change sharply reduced the progress of longevity in China. Its large lead over India in life expectancy dwindled during the following two decades — falling from a fourteen-year lead to one of just seven years.

The Chinese authorities, however, eventually realized what had been lost, and from 2004 they rapidly started reintroducing the right to medical care. China now has a considerably higher proportion of people with guaranteed health care than does India. The gap in life expectancy in China’s favour has been rising again, and it is now around nine years; and the degree of coverage is clearly central to the difference.Whether India’s democratic political system can effectively remedy neglected public services such as health care is one of the most urgent questions facing the country.


For a minority of the Indian population — but still very large in actual numbers — economic growth alone has been very advantageous, since they are already comparatively privileged and need no social assistance to benefit from economic growth. The limited prosperity of recent years has helped to support a remarkable variety of lifestyles as well as globally acclaimed developments of Indian literature, music, cinema, theatre, painting, and the culinary arts, among other cultural activities.

Yet an exaggerated concentration on the lives of the relatively prosperous, exacerbated by the Indian media, gives an unrealistically rosy picture of the lives of Indians in general. Since the fortunate group includes not only business leaders and the professional classes but also many of the country’s intellectuals, the story of unusual national advancement is widely and persistently heard. More worryingly, relatively privileged Indians can easily fall for the temptation to focus just on economic growth as a grand social benefactor for all.

Some critics of the huge social inequalities in India find something callous and uncouth in the self- centred lives and inward-looking preoccupations of a relatively prosperous minority. My primary concern, however, is that the illusions generated by those distorted perceptions of prosperity may prevent India from bringing social deprivations into political focus, which is essential for achieving what needs to be done for Indians at large through its democratic system. A fuller understanding of the real conditions of the mass of neglected Indians and what can be done to improve their lives through public policy should be a central issue in the politics of India.

This is exactly where the exclusive concentration on the rate of GNP growth has the most damaging effect. Economic growth can make a very large contribution to improving people’s lives; but single-minded emphasis on growth has limitations that need to be clearly understood.

Courtesy of The New York Review of Books.
          Health Care Advisor- Carltonville Mall        
West Rand, Gauteng - operations principles Desirable: Basic health, fitness and supplements knowledge Desirable: Knowledge of Merchandising Desirable: Knowledge... deliver to customer needs through knowledge and understanding of health and supplements. Job objectives: To consult with customers and provide...
          Health Care Advisor- Mall of Africa        
Midrand, Johannesburg - operations principles Desirable: Basic health, fitness and supplements knowledge Desirable: Knowledge of Merchandising Desirable: Knowledge... deliver to customer needs through knowledge and understanding of health and supplements. Job objectives: To consult with customers and provide...
          Ð‘ие даалтын сэдэв        

Оюутны  бие дааж судлах  зүйл.

1.     ÐÑ‚ом цөмийн бүтэц

2.     Ð“идродинамикийн үндсэн  ойлголт

3.    Эсийн  ба мембраны  бүтэц,  байгууламж

4.    N  ба Р   төрлийн  нөлөө дамжуулагчийн  шинж чанар. Хагас дамжуулагч өсгөгчийн төрөл,  ангилал,  онцлог

5.     ÐÒ¯Ð´Ð½Ð¸Ð¹ ба чихний бүтэц,  байгууламж

      Ашиглах   ном зүй

1.    Ж. Гомбожав,  Н. Мөнхцэцэг  “ Анагаахын физик”,  УБ   2004 он

2.    Л. Ажнай  “ Ерөнхий физик” /дадлагын  хичээлийн авлага/, УБ  2007 он

3.    Ж. Гомбожав  “Анагаахын биофизик”  1-р дэвтэр  УБ  1999он

4.    Н. Мөнхцэцэг  “ Анагаахын  биофизик” 2-р дэвтэр  УБ  2000он

5.    Л. Ажнай,  Ц.Сүхбаатар,  Н. Мөнхцэцэг, Ц. Оюунчимэг, П. Жаргалбат                            “ Дадлагын хичээлийн гарын авлага”   УБ   2009 он

6.     Ð. Амартүвшин ба  бусад, “ Биофизикийн дадлагын хичээлийн сорил”  2001он

7.    А. Самдан  “Физик”   УБ   1986 он

8.    James  E.Martin, John Wiley & Sons,  Physics  for  Radiation Protection

9.    Joseph  John Bevelacgua  2004, Wily – Vch Basic Health Physics

10. А.Н. Ремизов.  Медицинская и биологическая физика. М.”Высшая школа”

11. Н.М. Ливенцев. Курс физики. М. ”Высшая школа”   1987он

          Clinical Assessment in Primary Care - BSc         
The module prepares you as a first contact practitioner to undertake basic health assessments and formulate differential diagnoses for infants, children, young people and patients/clients who have commonly presenting problems in primary care. Module Code: NM3204
          Clinical Assessment in Primary Care - MSc         
The module prepares you as a first contact practitioner to undertake basic health assessments and formulate differential diagnoses for infants, children, young people and patients/clients who have commonly presenting problems in primary care. Module Code: NMM084
          So the voyage begins!        
Am now all packed and ready to jet out of the Midwest. Organizing myself was a bit more hectic than preferred, but has panned out well in the end. I now head over to Philadelphia for a couple days of orientation and then jet off to Niger.

My duty while in the Peace Corps consists of working within the Community Health Education sector, addressing basic health concerns in rural Niger. For the first two months while in Niger the Peace Corps conducts training emphasizing the teaching of local language and culture. Once finishing those two months I will move into a small rural village consisting of no more than 2,500 people, where I will be living for the next two years. Other than that much is still unbeknownest to me.

While immersed abroad it is always fantastic to hear from you 'non-Nigerian residents,' so keep the letters flowing! My address whilst in Niger for the first two months (as it will change once training is finished) is:

(My Name)
Corps de la Paix
B.P. 10537
Niamey, Niger

Here's a few tips to sending them:
1.Write “air mail” or “par avion” on letters and packages. They should take anywhere from two to six weeks to get to me.
2.Number letters so I’ll know if one goes astray.
3.Write the address in red ink; people are superstitious about it and will be less likely to open it or steal it.
4.Tape the corners of the packages so they will endure the trip. Also, putting tape or stickers on the inside of the flaps will make it easier to tell if someone tried to open it (and it may deter people from doing so in the first place).
5.Use padded envelopes whenever possible, as they are cheaper for both you and me. I may have to pay a tax on boxes, especially if it’s big or its contents are expensive. So don’t declare the items as expensive; keep it under $20.
6.When declaring the contents, keep it vague. Write “educational materials”, “personal hygiene items”, or “nutritional items” (for food), etc. If it doesn’t sound exciting, people will be less likely to open it. If you are sending me batteries, you have to “forget” that you packed them, as the U.S. won’t ship them overseas.

Thanks to all those who I saw for making it a memorable three weeks home after coming back from East Africa! Time to go catch a flight, next post I'll be scratching the sand from my eyes and being scorched from the pelting sun (well from what I hear at least).
          Doctors, Ethics and Medical Laws & Acts: The Impact        

The most talked about profession in society and media is Medical profession whether for right or wrong reasons. Why is it so? Because the necessity for survival is food water and good health. Our profession is one of its own kind which deals with human beings directly so every action of medical profession either bring bouquets or brickbats “MEDICAL PROFESSION IS A FEAT, IT REQUIRES SELF SACRIFICE, PURITY OF SOUL AND PURITY OF THOUGHTS”- A.P. CHEKOV There was a time when these lines had a real meaning. There were no laws and no acts and it was left to the conscience of doctors. Doctor commanded respect and had a unique place in the society. Even judiciary used to rely on the testimony of a doctor as sacrosanct. I remember in earlier times it was said that there are only two persons who can save the person from gallows – one President of India (Mercy petition) and the other a doctor if he says the person is medically unfit. There was no questioning for this opinion. But then came so many regulatory laws and riders. Medical Council of India was forced to prescribe a code of ethics and regulation act in 2002 and subsequent amendments. “The physician shall observe the laws of the country in regulating the practice of medicine and shall also not assist others to evade such laws. He should be cooperative in observance and enforcement of sanitary laws and regulations in the interest of public health. A physician should observe the provisions of the State Acts like Drugs and Cosmetics Act, 1940; Pharmacy Act, 1948; Narcotic Drugs and Psychotropic substances Act, 1985; Medical Termination of Pregnancy Act, 1971; Transplantation of Human Organ Act, 1994; Mental Health Act, 1987; Environmental Protection Act, 1986; Pre–natal Sex Determination Test Act, 1994; Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954; Persons with Disabilities (Equal Opportunities and Full Participation) Act, 1995 and Bio-Medical Waste (Management and Handling) Rules, 1998 and such other Acts, Rules, Regulations made by the Central/State Governments or local Administrative Bodies or any other relevant Act relating to the protection and promotion of public health.” What was the need to frame the laws and ethics? In India unqualified peoples (Amps) started practicing and they enjoyed political patronage. Since many of these people were not qualified and did not have purity of thought and action they started doing malpractices. Illiterate and uneducated and poor people could not differentiate between a qualified and quacks and any malpractice being done by these people resulted in defamation of profession. Then came liberalization of economy and the other services and businesses started flourishing,their officers started earning more that resulted in economic disparity. Doctor started feeling let down by poor infrastructure and poor remuneration. Govt failed in its duty to provide the basic health care to the masses resulting in overload on private health care. The liberalization led to development of health care industry rather than a profession. And the primary motive of industry is profit and not service to the humanity. The mushrooming of corporate hospitals in early 21st Century changed the face of medical profession and it became a business and an industry. All the unfair trade practices prevalent in other business or industry started creeping into this profession . Many qualified doctors resorted to unethical practices too to make quick bucks. This started an era of regulatory laws. Next came the Mandal Commission and reservation policies, with its woes. Politically driven agenda started polluting the Medical environment, along with the other streams. Undeserving creamy layers were mainly reaping the benefits intended for the needy. A general merit ranker of over 6000-20,000 got the opportunity to displace a merit ranker of 600, resulting in overall diminution of medical standards initially. And when this section entered the teaching stream the standard of whole subsequent breeds began plummeting meteorically. Problem was compounded by the fact that the Govt. (again for political reasons) didn’t keep any provision to differentiate between the reserved and general (in contrast to mandatory disclosure of a medical professionals qualification to differentiate between MBBS, Diploma, Degree, Doctorate etc) – thus denying the common people to make a informed choice. Due to incompetence of a select few the faith on the entire medical fraternity crumbled. Starting form Consumer Protection law to PNDT act and to MTP act lots of regulation came in .But when even these act did not deter those who were resorting to unethical practices and even small acts of omission and commission were highlighted by media . Medical council of India came with its new set of ethics and regulations and subsequent amendment to these rules were made on demand of public and media. This has led to loss of faith between the patient and doctor leading to chaos. Difference between ethics and laws- Ethics means self regulation and is a pious thing which comes from within and is self regulation while law is incorporating fear in the mind of individual. Need for law comes when self regulation fails and members do not practice ethical acts and behavior. Is law a deterrent and has it helped? This is the most important question that is relevant today. I think we have to look back and ask the following questions to the society and to ourselves- 1. Did the PNDT act improved sex ratio ? Is this act not in conflict with MTP act of 1971 : Initially the MTP act was promulgated to control the population but the advancement of technology – like use of ultrasound machine for sex determination led to sex selective abortion and misuse of act leading to decline in sex ration of female Vs Male. Then the PNDT act was brought to correct this anomaly and it was beginning of inspector Raj. The law created fear in the minds of medical fraternity and many doctors had to face the wrath of people for refusing to disclose the sex of unborn child. Another fall out of this act was-The inspectors – who extract bribe from the honest doctors on the pretext of falsely implicating them under this draconiac act. The genuine and legitimate need of USG in certain cases has become difficult and the sufferer is patient. No law can be perfect and there are exceptions, the latest is Supreme court was in a fix how to solve the puzzle of a minor girl who wanted MTP at 24 weeks.Ultimately even Supreme court shirked its responsibility on the collective wisdom of medical board and allowed the abortion. Similarly few months back another lady who wanted to abort a fetus with multiple congenital abnormality went to supreme court and it took 2-3 weeks for the supreme court to decide the question of laws which further aggravated the situation and ultimately nature did its job and lady aborted spontaneously. 2. Human Organ Transplantation act – Did it help? This act was made to prevent the exploitation of gullible and poor patients. But this resulted in many patient being denied the transplantation.Many lives have been lost while implementing the time consuming provision of the law to get the permission. The act had to be amended again on the advise of medical experts only 3. Consumer protection law – Misuse? Did it help? This is the law which damaged the Doctor- Patient relationship to an extent which seems to be irreversible. Open the newspaper and you can find daily news of astronomical amount of compensation being awarded in the name of negligence by doctors. This led to a newly coined term ‘DEFENSIVE MEDICINE” which every doctor is practicing now. Who is sufferer – Patient and specially poor patients for whose benefit this act was promulgated. Doctors are forced to prescribe lots of investigation to confirm the diagnosis which is clinically evident to escape the charge of negligence. Law only recognizes evidence not the intention. Friends many of us do not want our children to opt for this profession for worsening doctor patient relationship, hard life and poor remuneration and fear of law which is liable to be misused rather than be of help to needy. Remedies – What is the solution I think all of us along with civil society members and judicial members should sit together and think again. My personnel view is – MCI should be given all the powers to regulate this profession and to fix the acts of omission and commission and to award the compensation if required. The emphasis should be on self regulation rather than making more laws. Bar council of India is already vested with powers of self regulation and why not MCI. How to attract good and honest people into MCI should be the topic so that SELF REGULATION leads to establishment of doctor patient relationship to an extant where doctors practice this art without fear of law. You can take the horse to the water but can not make him drink. It is the conscience and purity of thought and action and a HIPPOCRATIC OATH which works. P. S.: Above article has been taken from a message in WhatsApp group.

The post Doctors, Ethics and Medical Laws & Acts: The Impact written by Dr. Paresh Koli appeared first on Desi Medicos.

This is a letter I received from the Chairman of The Children Movement of Florida, I am thankful for his efforts. His letter is a wake up call to every one of us,  are we doing enough to protect the future leaders of our beautiful Nation? 
Here is what Dave has to say.... Happy 4th of July!

While we celebrate, let us remember...
Dear Gladys:
I’m a student and reader of history – usually at least a book a week – and my work with The Children’s Movement is built upon what I learn. I believe that a “movement” is about all of us and all children. In my estimation no progress in human history – with the exception of science and medicine -- was achieved with anything less than pushing and shoving. The civil rights movement, the feminist movement, the very birth of our country – none came without people pushing…shoving…insisting (while, yes, trying to be courteous whenever possible).
On this day of celebration of freedom, I look back on the progress that we’ve made (and there has been progress), and find myself sobered by the statistics that tell us how much further we must go:
  • The more than a half-million children in our state without basic health insurance.
  • 38 percent of our public school fourth graders cannot at grade level – and 90 percent of Florida’s children go to public school (and far higher amongst minority children).
  • Almost a quarter of Florida’s children live in the full federal definition of poverty. (How can this be in the richest, most generous country in the world?)
Today, as we celebrate our much-blessed country, let us not forget that nothing is more “American” than our insisting that every child has the chance to succeed in both school and in life.
Dave Lawrence
The Children’s Movement of Florida


          Top 4 Tips for Caring for Your Horse        
It's important to take your horse to the vet for regular checkups. However, since you are the one who's around it all the time, it is more crucial that you familiarize yourself with basic health care tips to make sure you can administer aid to your horse in case it needs immediate medical attention. TAGS: horse supplements, online horse supplies, horse supplies online
          Accountability Now PAC        
New PAC Will Use Primaries to Hold Incumbents to Account:

Effort Will Challenge Vulnerable Members of Congress Who Side with Corporate Interests Instead of Constituents

Click here to donate today!

Washington, DC — Accountability Now PAC announced its plans today to use primaries to hold incumbents to account for voting with corporate interests instead of their constituents. The new PAC is a grassroots effort devoted to compelling real accountability in Washington by closing the gap between citizens and their elected representatives in Washington, DC.

“We need members of Congress to leave the bubble of Washington, D.C. and stand with their constituents,” said Jane Hamsher, founder of and co-founder of Accountability Now. “We need members of Congress to ask the tough questions about continued Wall Street bailouts that reward the donor class, two wars without seeming end, the ceaseless assault on our civil liberties, and other issues that separate the citizenry from the DC cocoon.”

“Accountability Now is an organization built around a single guiding principle: challenging the institutional power structures that make it so easy, so consequence-free for Congress to open up the government coffers for looting by corporate America while people across the country are losing their jobs and their basic constitutional rights while unable to afford basic health care,” said Glenn Greenwald of and co-founder of Accountability Now. “Accountability Now believes that members of Congress in both parties need to hear from their constituents, and that nothing focuses the mind of a politician on listening to citizens better than a primary.”

“Accountability Now PAC will recruit, coordinate, and support primary challenges against vulnerable Congressional incumbents who have become more responsive to corporate America than to their constituents,” said Accountability Now’s new Executive Director, Jeff Hauser. “By empowering the grassroots, Accountability Now will help create the political space needed to enable President Obama to make good on the many progressive policies he campaigned on - such as getting out of Iraq, ensuring access to affordable health care for every man, woman and child, restoring our constitutional liberties and ending torture.”

In 2007, grassroots activists banded together to oust Al Wynn out of office, and it shook House Democrats to their core. Similarly, we learned in 2006 how even a primary challenge that does not win could change behavior, as Jane Harman has been more accountable to the concerns of her constituents after a tough primary race against Marcy Winograd.

Out of these recent lessons, diverse and politically powerful groups have decided to support Accountability Now’s efforts, such as MoveOn, the Service Employees International Union (SEIU), DailyKos,, and Democracy for America, 21st Century Democrats and BlogPAC.

          Thatta Kedona Ki Kahani        

Thatta Khedona -A Pak-German Initiative For Doll-making and Women Empowerment

Duriya Hashmi

Around twenty five years ago, Amjad Ali, a Pakistani expat and his German friends Senta Siller and Norbert Pinsch came up with the idea to give an opportunity to craftswomen of Okara to showcase their handmade dolls in Germany. It was just a matter of few more years that the trio became a household name for the villagers of Thatta Ghulamka Dheroka,Okara. The small project aimed at women doll makers quickly transformed into a significant development project providing support for child education, basic health units, livelihood and solar energy needs of the people of a remote village in Okara. For his commitment and passion for the social uplift of local people, locals of Okara and the German sponsors mutually decided to call one of the project 'Amjad's Village' named after the co-founder, Amjad Ali who is loved and respected by all in Thatta Ghulamka Dheroka.


Some of the footage in the Video is taken, with due permission from Amajd Ali, and contains clips owned by PTV and Afsar Awan
Images: Ali Raza Jaffery , Amjad Ali
Music: East Side Story

          Romance of Amjad’s Village        
What started in 1991 when DGFK produced the movie titled "Amjads Village" in the small Pakistan village Thatta Ghulamka Dheroka (called Dolls Village located 80 Kilometers from Lahore) became a great project famous all over the world. Thanks to the volunteers who kept coming in the village and kept training the local girls and boys in skills to preserve the unique rural culture as and at the same time, generate additional income for the participants. In the meanwhile, dolls and toys produced by the villagers traveled in the boxes of foreigners and diplomats everywhere.

The huge numbers of volunteers who have been associated with the project are now a very closely knit community. They meet together and update each other whenever there is a possibility (or when they can create a possibility). On 26 June 2017, some volunteers had an informal meeting in the old and new centre of Berlin, and had a blast from the past.

Dr Senta Siller who has become a household name in the Village because she has taught handicrafts to almost every girl in the Village. Not only that, she has practically lived in the Village for almost three decades. Also, Dr. Farida Khawaja who assisted her with translation and local consulting. Dr Senta Siller established Women Art Centre (WAC) in the Village in 1993 that is working research, design and management consultation centre. Dr Leila Masson, who was in the Dolls Village for 18 months during 1991 and 1993, and who laid foundation of the Basic Health Unit (BHU) in the Village and served as a medical doctor there during her stay?

Prof Norbert Pintsch - a researcher, architect and engineer – who set up Technology Transfer and Training Centre (TTTC) in TGD in since 1996 TGD and is working as project and Consultant ever since.

A guest lady Nadine Kessler also attended the meeting. 

Thanks to active participants of local NGO Anjuman-e-Falah-e-Aama, the Village has changed overtime. During the years, large number of foreigners and locals traveled to Thatta Ghulamka Dheroka, electricity came to the village, fruit and flower trees are in each home, water pond and drainage systems are working, and now the solar power has changed the way people live in the Village.

          Preservation of Gogera Heritage         
Preservation of Cultural Heritage

in Co-Operation with
German Society for the Advancement of Culture
Special Report by S A J Shirazi
This report reviews the situation of the cultural heritage in Pakistan and in particular it focuses on Gogera Fort, gives inventory of the fort and proposals for its preservation as well as management. Part II of covers the poverty alleviation and self help activities of community based local NGO Anjuman-e-Fala-e-AAma working in cooperation with German Society for the Advancement of Culture (DGFK) in Thatta Ghulamka Dheroka – Punjabi village famous all over the world for dolls and toys made here and developments taking place in the process. The report also covers the details of some of the tourists’ attractions in the historic breadbasket of Pakistan around Thatta Ghulamka Dheroka. This part of the report should be read along with the map of the area.

Preservation of Cultural Heritage in Pakistan
1. Pakistan, a young nation forged in the crucible of one of the world's oldest civilizations possesses a unique heritage. It is one region in the world where a complete cultural profile from the Stone Age to the Islamic period exists in some form or the other. The archeological treasures the glory and grace of civilization of the past, and they badly need attention for their preservation and protection before they disappear forever. Pakistan’s heritage consists of archeological remains, monuments, settlements, individual buildings, trade routes, mountain passes and works of arts. These tangible cultural assets are of great historic, archeological, architectural and artistic merit.

2. There is a wide range of practical reasons why the historical buildings and monuments should be preserved. The built heritage have both aesthetic and economic values: they stimulate inquiry, business enterprise, and social, religious, research, and academic interest. They provide recreational enjoyment for resident and visitors alike, and they serve as places of residence. A country's heritage also provides insight into the social, political, economic, cultural and technical forces and values that have fashioned it. The economic benefits and financial costs associated with conserving and preserving heritage features can be measured.

3. Sadly, the condition of built heritage of the country is not very satisfactory. Reasons: lack of physical and financial resources to maintain and conserve them. Which is why many have deteriorated and even decayed? Of great concern is the fact that these national resources, if and when they do receive attention are largely dealt in isolation. The more important dimension – the area conservation – is not there in Pakistan.

4. The nature of the forces at work either favoring or diminishing the continued existence of the heritage resources is of the paramount importance. In Pakistan’s case these forces are largely negative. The nation’s built heritage is decaying naturally, and that deterioration is being accelerated by human activities. The causes are rooted deep in economic, social, educational, political and legislative activities. Past policies have focused on industrial and economic growth at the cost of environmental issues and the quality of life. Natural resources have been indiscriminately exploited, resulting in ecological imbalances with detrimental effects upon the country’s built heritage. Industrialization, irrigation system, deforestation, and urbanization have also taken their toll.

5. But there are examples of excellent conservation work too. Nice jobs have been done in shrine of Shah Rukn-e-Alam and Services Club in Multan. Renovation of some of the Sikh Gurdwaras and Hindu Mandirs dotted around Pakistan is also good example of conservation of historic buildings. But much more remains to be done.
Existing Legislation

6. Existing policies for the preservation of built heritage in Pakistan and province of Punjab are framed by two pieces of legislation: -
a. The Antiquities Act 1975. This act supersedes the Ancient Monument Act 1904, and is administered by Government of Pakistan. The act provides for the listing of historic monuments and sites as protected monuments, the preservation of demolition, alteration and the erection of new developments with in 200feet, with penalties and fines or imprisonment for infringements and the preparation and implementation of repair schemes funded by the Federal Government.
b. The Punjab Special Premises (Preservation) Ordinance, 1985. The ordinance is administered by the Department of Archeology, Government of Punjab. This ordinance has similar provisions as the Antiquities Act.

Gogera Fort, History

7. Once an important and dignified town in the plans of the Central Punjab, Gogera today is only a shabby and sleepy suburb of Okara on the bank of river Ravi on Okara Faisalabad Road. (Fasilabad was founded by Lieutenant Government Punjab, Sir James Lyall in 1896. The plan of Fasilabad was prepared on the pattern of British flag by sir Ganga Ram, a civil engineer, town planner and renowned philanthropist). Gogera town still boasts its importance when it was British power center and district headquarters from 1852 to 1865 and the part played by the resilient people of the area during War of Independence in 1857. The stories of the war that was fought around Gogera echo in the pages of history books.

8. On May 13, 1857, the news of British military actions at Mian Mir (Lahore) reached Gogera that set off the chain of events. As a result of what happened in Lahore, Ahmad Khan Kharal and his companions broke Gogera central Jail on the night of July 26, 1857. Deputy Commissioner Elphinstone and Extra Assistant Commissioner Gogera Berkley (locals pronounce bar killy) fought the people of the area. Many adjoining villages including Jhamra - village of Ahmed Khan Kharral - were burnt and innocent people killed in search of Ahmed Khan Kharral and other freedom fighters. Troops and artillery guns from Lahore and Multan Garrisons also reinforced the Gogera based British army. British suffered heavy losses including killing of Berkley. Save the last resting place of Berkley, there is nothing much left on ground that could be associated with he War of Independence or bring back the memories of the days gone by. Signs of the grave of Barkley are also fading fast. British government should consider building a monument like an obelisk built at Killa Kohna Qasim Bagh in Multan or in village Chelianwalla (not to be confused with Jallianwala Bagh) in district Mandi Bahauddin, both constructed in the memory of British officers who were killed there.

9. The circumferential walls of a Christian colonial cemetery housing the last resting-place of Lord Berkley can also be seen neglected ever since. The British Government had allotted agricultural land to the local trustees for upkeep of the cemetery but they could not preserve this important historic sign. "The parameter had been used to keep the animals in the past," told my host Alam Sher, a photographer and social activist who accompanied me during the field survey of the area. I asked many locals but no body could indicate the place where used to be Gogera Central Jail.

10. The history of any building begins from the first day of its creation, sometimes even earlier than that. It continues through its long life to the present day. A historic building has an artistic and human message, which can be revealed by the study and exploration of its history. A complexity of ideas and of cultures may be said to encircle a historic building and be reflected in it - Architectural Style – Gogera Fort

11. An old building - a British court - that reminds of the colonial period has been converted into a school. The verandas of the old building with round arches have been clogged to create additional rooms and red thin bricks are covered with coats of whitewash. It was much better if the building could have been conserved in its original shape. That does not seem possible now.

12. Just in front of the school is dilapidated and crumbling Gogera Fort with its round corners towers. There are few rooms and an old Bakhshi Khana inside the fort. Who built the Fort and when is not known. Legend has it that it was built before the Mughal era. UNESCO experts associated with Lahore Fort say, the Fort is at least 400 years old." May be it was built by any of the chieftains in the area as a private safe house. The British used the place as a treasury and also to keep the prisoners before and after appearing in the court.

13. The architects of the Fort used mainly brick. In the absence of fine stone, which was not readily accessible in this part of the world, brickwork of remarkable quality was produced. Presently, the brickwork has been covered with mud plaster and coats of white wash at places. The broad and thin bricks like those used by the roman builders have been used. To ensure additional strength, bricks are used in upright courses in four lofty and rolling battlements of the Fort - like huge chimneys in each corner (Corner towers have about 7.8 meters circumference. The walls of the towers are 60 centimeters thick). There is a guard post in front of the western gateway, which is used as main entrance to the property.

14. The barracks along the parameter walls have vanished. The treasury room inside the complex is still in tact and is being used as a living room these days. The huge bargad (banyan) tree in the compound is an abode of squirrels and common birds. There is also a water well in the courtyard on which electric pump has been installed that serves as a source of drinking water for the residents. Sitting in the shade of old tree, one may think about the secrets hidden in the monument, which we are poised to loose forever, if due attention is not paid to it soon.
Present Status
15. After the British rule, partition in 1947 once again changed the socio-economic order. Historically, all properties that fell in the hands of the emigrants from India were allowed to seed and disintegrate. Since independence Gogera Fort has been home of the family that migrated from India. But the family has not been able to keep the fort’s lore. Agricultural family occupying the fort is not even aware of historic, symbolic or aesthetic values of the building that is their home.
The Idea
16. A road bifurcates towards north from Gogera town and leads to village Thatta Ghulamka Dheroka (TGD) in the backwaters of the Punjab. The village has become famous all over the world for dolls and toys made here by village folks. Volunteers from German NGO DGFK are working in this village since 1992. Aside from locals, large numbers of foreigners interested in rural culture, social work and poverty alleviation, and experts in different fields of human activities come to this village and pass by the grand building of Gogera Fort. Community based local NGO Anjuman-e-Fala-e-Aama is working in cooperation with DGFK under direct supervision of two full time volunteers Dr Senta Siller and Dr Norbert Pintsch.

17. The idea of the conservation of the Gogera Fort and turning into a monument not only for the foreigners who frequent this area but also for next generations has become one of the active concerns of the NGO. Norbert Pintsch, Volunteer Project Director Technology Transfer and Training Center for Men in TGD, an Architect by profession and social worker by choice is taking keen personal interest in this project.
18. Importance of Gogera Fort is Multidimensional. Its conservation should include all necessary actions (by specialists only) to enhance and perpetuate the life and existence of the Fort. The purpose of this noble endeavourer is to retain, as far as possible, the history, the traditions and cultural values being presented by this archetype to those who use and look at it with wonder.
Finance and Management
19. NGO Anjuman-e-Falah-e-Aama [registered under the Voluntary Social Welfare Agencies (Registration and Control) Ordinance, 1961 (XLVI of 1961) at Lahore, vide Government of the Punjab, Directorate of Social Welfare Registration Number DDSW-LD/92-405 of March 17, 1992] has deep routes in the area and is equipped with expertise and knowledge. The NGO has earned trust due to its transparent work and sincerity of purpose. Aside from turning Thatta Ghulamka Dheroka into a model village, the NGO can turn the idea of Gogera Fort as a useful monument into a reality.

20. A partnership will be needed to mobilize all resources: international agencies, foreign governments, NGOs and private sector. UNESCO and ICOMOS are involved in technical assistance and publicity rather than direct financial aid. The Gattey Organization, Agha Khan Foundation and various western governments have had long-term involvement in monuments all over the world. Financial assistance of Norwegians for conservation and preservation of the Sikh Imam Dean Tomb near Peshawar, technical assistance of Oxford Brookes University (UK) in completing documentation of various historic buildings in Pakistan or long term German involvement in the monuments of Baktapur, Nepal are some examples in this regards. Public departments may be approached for technical assistance, grant of protected status and improvement in infrastructure in the form of roads and telephone.

21. In such projects it is generally accepted that there will be some measure of cost recovery, so that the customers ´pay as they use’ the facility (entry fee, may be).
22. The Gogera Fort is a personal property of the family. The family also own agricultural land around the Fort. This fact makes (in a way) obligatory to involve the owners in the conservation and later management plans of the Fort.
23. There are number of national and international institutions, which may be involved in matters relating conservation of historic fort. Some of the institutions that can help are: -
a. National
- Department of Archeology, government of Pakistan
- Department of Archeology, government of Punjab.
- Auqaf Department, Punjab
- Municipal Committee, Gogera
- Okara District Government
- Pakistan and Punjab Tourism Corporations.
b. International
- Non Governmental Organization
- Foreign Governments
- International Commission on Sites and Monuments (ICOMOS), a subsidiary of UNESCO
- Agha Khan Foundation
- IUCN- The World Conservation Union
c. Private Sector
- Industrial concerns (like Tobacco and Soft Drinks)
- Individuals
Visitors and Tourists

24. People travel for many reasons: to see the things they can not see at home, to get away from the routine of life and work, to meet interesting people, to study different cultures and or to seek spiritual solace. For last decade, TGD has become a unique village to attract large number of foreigners. Only in year 2000 travelers (including experts in different fields and social workers) from 40 different countries visited this village. And, most houses in TGD have built guest rooms for visitors who come here and stay as paying guests in homely atmosphere – clean linen, local cuisine and traditional hospitality. From Gogera one can ride a traditional horse drawn Tonga or an auto rickshaws to TGD on Gogera-TGD Heritage Trail.

25. History and archeology make for good tourism that is largely a function of prosperity. The more money people have the more of it they will spend on travel and other intellectual pursuits. Today, worldwide tourism is an unprecedented 4.4 trillions dollars industry expected to be 10 trillions by 2010. Now once every beach, airport and other conventional tourist spots feel crowded like a cinema hall, people are constantly looking for quiet, unique and brand new destinations. Millions of tourists come to Asia every year. But the irony is that out side world does not know about Pakistan or has a distorted image of it; hence tourists cannot plan to visit. After all, Pakistan has much more to offer than many other countries combined together.

26. Tourism in Pakistan is only in an embryonic state. There is a need to develop sustainable tourism; a concept that implies that action taken now should be for the benefit of, and not on the expense of, future generations. Both Public and Private sectors should be motivated to come forward to support tourism in the country. And, there is a lot of untapped potential in this field.

27. Historically, archaeologically and geographically Pakistan is a place of antiquity and great importance. No ordinary coldness of phrasing can express the surprise and delight, with which one makes acquaintance with the heritage sites spread all over Pakistan. In part three of the report, some places of interest for visitors have been described.

28. Gogera Fort is located in historic tapestry. Besides activities in TGD and famous Harrapan ruins, there are many other reasons to visit the area and the Fort. Some of the interesting places around Gogera Fort have been mentioned in elsewhere in the blog.
UNESCO Program of World Culture Heritage Global Strategy
29. A Global Strategy for a balanced and representative World Heritage List, adopted by the World Heritage Committee in 1994, aims to ensure that the List reflects the world's cultural and natural diversity of outstanding universal value. Conferences and studies aimed at implementing the Global Strategy have been held or are planned in Africa, the Pacific region, the Arab region, the Andean region, the Caribbean, central Asia and Southeast Asia.
Activities of AeFeA
30. Since first visit of Dr. Senta Siller and Norbert Pintsch to village TGD in early 90s, so much has happened and so much has changed. National and international print and electronic medias have extensively covered the activities of the village. Only two of the articles are being reproduced in this section: - Dolls from Pakistan(Selling Pakistan Abroad) The cluster of mud and brick houses in the plains of Punjab, TGD looks like a typical Pakistani village about 80 kilometer away from Lahore and 40 kilometers from Indus civilization ruins in Harappa. There is no gas or telephone in the village. No matelled road leads to it. Even the electricity is a recent phenomenon. Yet it is different; the beautiful dolls and other handicrafts made here by the village women are collectors delight all over the world. Influences from Indus civilization from near by Harappa and modern techniques brought by the German volunteers can be seen in the village together.

31.They dolls made in the village are on display in International Doll Museum in Iceland, prestigious galleries and show rooms in Pakistan and abroad. TGD village doll - registered as Amjad's Village Project - was one of the 767 worldwide projects presented in the "Themepark" at EXPO 2000 in Hannover (Germany) as an example of thinking for 21st century. Earlier, the dolls from Pakistan participated in International Toy Fair in Nuremberg. In 2001, on a special invitation from Dubai Shopping Festival, the dolls were displayed and were appreciated not only by Arab royalty but also by the general public. These dolls show how culture goes beyond simple work of art and becomes collaboration among applied and natural sciences as well as other forces that affect our lives. Dr. Senta Siller, after her meeting with S. K. Tresslar, Minister for Culture and Tourism informed, "we are going to open a display and sale shops in museums where cultural artifacts made I village TGD will be kept. We will start from Lahore Museum and later expand to all." How all this started? A Pakistani studying in Germany, Amjad Ali who is a native of village TGD invited his German teacher Dr. Senta Siller to visit his village back home. Dr. Senta Siller (and Norbert Pintsch) came to the village where she was presented a doll made by a local woman. Dr. Senta Siller was impressed by the doll and liked the natural and simple village life. She decided to work for the village, established NGO Anjuman-e-Falah-e-Aama and started community-based Women Art Center in TGD in 1992.

32.The aim of this center is to involve local womenfolk in productive, creative and healthy income generating activities. She created awareness and built confidence among the women, specially the young girls of the village and asked them to manufacture dolls and toys on self-help basis that she is now marketing all over the world. The village and its residents are benefiting in the process. Some people live and make difference in the lives of others. Born in 1935 in Vienna (Austria), Senta Siller took refuge in Germany following the Second World War. After graduating from School of Arts in Berlin, Senta Siller knew that she has found her métier: designing and illustrations. As a designer, she has worked for exhibitions, fairs, children's cloths, toys, and books' illustration and also ran a textile company. She has done masters in Archaeology, Philosophy, Education and doctorate in the History of Arts. Civil servant appointed for life, she has been given different awards including "Bundesverdienstkreuz" - the highest order of merit of Federal Republic of Germany as recognition of her dedicated services to humanity. When women's initiative groups read about Pakistani dolls in the newsletters of DGFK, they invited Dr. Senta Siller to start similar projects and to train women in doll and toy making in Cameroon and Colombia. She started her voluntary work to train multiplictors in both the countries in 1997. The expatriates booked dolls in advance and other support in marketing came from volunteering ladies of the German community in the respective capitals. Presently, Dr. Senta Siller is networking among the women activities in all these countries. Dolls from Pakistan in authentic attires of the specific tribes, communities and areas tempt visitors, tourists and diplomats. They collect these dolls as a souvenir of the time they spent in Pakistan. "During last six years, the Pakistani dolls went in suitcases of our client to 40 different countries. They sit in the Ambassadors' residences not only in Islamabad, but accompany them to the next and second next postings. I met TGD dolls in the Japanese ambassador's home in Jakarta and also in the German embassy in Damascus," tells Dr. Senta Siller with pride and pleasure. "Part of the artists go where ever the dolls go, " says a young artist. Each doll has a small plate attached carrying the name of the doll maker.

33.Doll making is one of the oldest and popular traditional folk art in Pakistan. Simple stuffed dolls are made for children, particularly in rural areas where people are still striving for the attainment of basic needs. The main difference of previous doll making and the modern techniques taught by Dr. Senta Siller is that she has introduced variety in size and shapes and dressed them in colorful costumes with attentions to details. This has resulted in high quality soft toys to cater to demands of the gift market.

34.Dr. Senta Siller has not only moved the women of the area but also raised a spacious and simple building for the Women Art Center with the help of German Embassy. She even managed Solar Energy System - probably the first in Punjab - for the center with the assistance of Embassy of Japan. Besides clay lamps, that used to be the only source of light before the village was given electric connection in March 2000. Now there are as many as 120 women - from the age of 24 to 40 - working in the center, making dolls dressed in Punjabi, Sindhi, Pathan, Balochi, Kashmiri and Kallash embroidered costumes, miniatures, hand knitted shawls and many more items and earning their living. They are making their own lives better and strengthening their families. "They (the women) are moving towards true equality and independence," says a doll maker who has twelve year of schooling, married in this village and working in the center. Dr. Senta Siller is already planning to expand its working to neighboring villages.

35.Technology Transferred Training Center (TTTC) for Men has been established under the guidance of another German Norbert Pintsch - energetic and industrious volunteer - where village boys are being trained in different skills. Workshops on construction, appropriate technology, toys, tourism, transportation and agriculture are functioning in the TTTC. Some of the men of the village have already been trained in vocations like electricity wiring, motor winding, plumbing, tailoring, driving, book keeping and livestock vaccination.

36.The main emphasis is on progressive farming and use of improved agricultural techniques with particular reference to area specific agriculture, water, and soil and animal problems in TGD. Workshops and seminars are attended by large number of experts (including professor L.A. Hijazi, Professor Ghulam Jilani students of Barani University Rawalpindi) and local formers.

37.As per the survey conducted by the NGO, the men of the village conventionally are occupied in farm work whereas women are busy in household to the extent that children are fully ignored. Underground water is quite safe for irrigation as well as drinking purposes. Water available to livestock is not clean. The elders are not ready for new and improved practices in agriculture. Farmers prefer to own more livestock as prestige with the result that livestock rearing is not economical due to unproductiveness because of lack of fodder, feed and unhygienic rearing. There are 1000 buffaloes, 800 goats and sheep and 60 pairs of bullocks in the village. Early marriages are common practices in the rural society.

38.About 640 acres of agricultural land is available in the village. In opinion of the experts visiting the village, it is suggested that a switch over to high value crops (Jamboo fodder, bajra, napier, hybrid grass, sunflower, vegetables and cut flowers) and improved livestock production practices through training and demonstration are the solutions in order to increase the yield as the land can not be increased. It should be done along with other forms of cottage industry development like honey bee keeping, poultry, fish farming, back yard orchard development and vegetable farming for home consumption and imparting off-farm vocational training.

39. At present it is difficult to convince farmers for a switch over as recommended by the experts because of their poor economic conditions and lack of risk bearing capacity. Their present farm production practices provide them with a subsistence guarantee. The immediate solution could be to sing an agreement with them, after appropriate training and providing them with required inputs, to pay the differences if new practices fail to produce lesser than their present ones.

40. An annual Quality of Life competition is held in the village when best houses are selected in three different categories. The villagers work with three-panel-wall, like in Harappa, several thousands year ago, using local material with good conditions for the climate. The Chief Explorer from Harappa Dr. Mark Kenoyar had places in the jury for the competition held July 2000.
Beautiful tradition that has matured in the tranquil hamlet is that every newly married couple is presented a fruit tree whereas parents of every newborn get flower tree by the NGO. Result: one can see blooming bougainvillea creepers and fruit trees in courtyards of each house. Murals are painted on the parameters wall and large mud containers for grain. And, each house has a guest room for visitors who come here and stay as paying guests in homely atmosphere. Village TGD is changing. The relative prosperity has beginning to show. Villagers are putting their children, particularly the girls in school. The Woman Art Center is also playing a part in the well being of the village. The center has provided furniture and other equipment to the primary school in village and opened a well-equipped Health Care Center. Which is why the village women remember medical doctor Laila Mason – who first established the Health Care Center - with affection. Groups of foreigners and local journalists, social workers and intellectuals visit the village under the programs like 'Development of Education and Culture in Rural Areas'. Such visits are very festive events. All villagers participate in the celebrations. The center exhibits the handicrafts. A cultural show (including camel and horse dances, folk music, dhol (drum) dance and puppet show) are arranged on the occasions. The traditional functions also attract large number of people from adjoining villages. In addition to raised income, increased awareness, enhanced opportunities, peace and security, participation and sustainable future help to defeat poverty. Improving livelihoods enhances women's self esteem, their confidence and their power to make decisions and their position in the family. The women and their families benefit, and their communities prosper.
Poverty is winning
41. Women can change it Poverty in any form is a denial of human rights. It is more plausibly judged by the reduction of deprivation than by the accumulation of additional wealth with 'have' class. The conventional economic indictors like Gross National Products and Gross Domestic Product can hardly capture the implications of these high sounding terms on the 'have not' class. And, there is no single yardstick that can be used to satisfactorily define poverty. And, income poverty is only a narrow approach to address the complicated issue. Nevertheless, for convenience sake, poverty can be categorized as absolute, relative and subjective.

42. The concept of absolute poverty involves determination of basic needs that are measured in terms of resources required to maintain the average well being of an individual, family or group of individuals called society. These resources may include the quality and quantity of food, clothing, shelter, basic health care and education: the basic requirements of life. If these basic necessities are priced and someone's income level falls below that figure, it marks absolute poverty. But an argument still holds that the basic needs also vary among people in the same society. For example, a laborer living in a cosmopolitan like Karachi needs different things than another laborer living in a remote area of Sind or Punjab.

43. Poverty has good reasons to celebrate. The last few years have seen an increase of 20 percent of those living under the poverty line the world over, bringing the number to a staggering 1.2 billion. Looking at its diversity, even absolute poverty is an incomplete gauge to determine poverty. But as is the case with most statistics, the figures remain just that - mere numerical data that leave one untouched. The figure cannot project the numbing visual imagery of misery, denial, helplessness and surrender of spirit. Instead, it can be replaced with standards that are relative to a particular time and place, which are as acceptable as a style of living and quality of life in accordance with the conventions and requirement of the day. Any definition of poverty must be related to the needs and demands of a changing society: from simple to complex. The living conditions of a relatively poor man in the same society might change with time and, therefore, a problem of comparison does not hold water. In short, circumstances and expectations usually differ with time and from place to place.

44. In this regard, comparisons are invalid. Different standards of poverty are required based on relative poverty according to the convention of the particular society and its actual needs. Poverty can be better compared in different societies from these viewpoints. "But why compare it, why not do something to alleviate it," says a German volunteer Dr. Senta Siller working in rural areas of Pakistan. Subjective poverty is poverty with a difference, that is, the poor have to accept or feel his poverty, not from the assessment of onlookers - a wealthy businessman who can no longer sell for an expected economic profit per day considers himself to be poor, while relatively poor stills consider him to be rich looking at his lifestyle and income level. Alternatively, individuals or groups who do not see themselves to be poor may be judged by the majority to be in poverty. The perceptional nature of this concept makes it unique. Most significantly, what defines the situation of the poorest people is their insecurity and vulnerability. For example, an unskilled laborer in the remote part of Pakistan like Cholistan or Thar, who is engaged in subsistence farming, would be vulnerable to rising unemployment caused by the economic crises during extended dry spells. In short, the poor suffer from a variety of disadvantages, all of which interlock with one another to create an uncompromising and perpetuating poverty trap.

45. Income levels vary and, as a result, poverty exists. No human being is meant to be poor, but in most cases the prevailing systems (economic, political as well as civic) subject one to be. Since it is difficult to change a system overnight, the individual can change to beat the system strategy to end poverty. Based on this premise, the Women Art Center (WAC), a female centered Non Governmental Organization in Thatta Ghulamka Dheroka (TGD) - a village in the backwaters of Punjab 80 Kilometers from Lahore caters to defeat poverty of rural women by increasing their income levels through diverse income generating activities. Over 200 rural women who are benefiting from this scheme are engaged in toy making, which are sold all over the world by the NGO.

46. In addition to raised income, increased awareness, enhanced opportunities, peace and security, participation and sustainable future help to defeat poverty. TGD has a primary school for girls. The first girl named Shazia who was allowed to go to higher secondary school in a nearby town Gogera was gifted a lady bicycle by the WAC. The girls of the village taught Shazia how to ride and came to see her off on the first day of her school that is situated about four Kilometers from TGD. It was a very sentimental occasion. How many villages in the world can boast off all of these characteristics? Just as poverty is not solely a matter of lack of income or perpetual, want, it follows that its eradication must be achieved through strategies, which enhance the ability of local communities to adapt to stress, overcome emergencies and improve long term productivity. In this regard, WAC holds the views that income defeats poverty as the women of this village are today economically above other rural women. If these women can defeat poverty through hard work to increase their income levels, why not others, this question keep coming to my mind?
Places 0f Interest Around Gogera Fort
Down to Dipalpur's Beginning
Dipalpur is famous in the history as an outpost that has played a significant part in the defense of Delhi kingdom against Mongol invasions in the thirteenth and fourteenth centuries. The coins of Sakas (Scythian) period found on the site suggest that the place was inhabited in 100 (BC). After Multan this is probably the oldest living city in the subcontinent.

History of Dipalpur dates back to ancient times. General Alexander Cunningham writes that the place figures out in works of Ptolemy under different names. As per the tradition, Dipalpur was named after Raja Dipa Chand once he captured it.

Dipalpur once used to be the first fortification in the way from Khyber to Delhi. In 1285, Muhammad Tughlaq son of emperor Balban was killed in a bloody battle with Mongols and the famous poet Amir Khusuro was taken prisoner in Dipalpur. The dilapidated tomb where Muhammad Tughlaq rests stands neglected in a silent corner, for removed from the noisy haunts of men. Under Ala-ud-Din the town became the headquarters of Ghazi Malik. Feroz Shah Tughlaq visited the town in fourteenth century. Mughal Emperor Akbar made it the headquarters of one of the sarkars (revenue district) of Multan Province. The town lost its importance during colonial era. Partition changed the face of the town and it witnessed the new demographic and socio order in 1947. It is now a tehsil headquarters of Okara district.

Dipalpur in the past was surrounded by a fortification wall, rising to the height of 25 feet and strengthened by a deep trench and other defenses. When and by whom this fort was constructed is not known. But it was renovated, repaired and improved during the rule of Feroz Shah Tughlaq and later by Abdur Rahim Khan-e-Khanan who was the governor during the time of Akbar. Feroz Shah Tughlaq constructed a grand mosque, palaces and excavated a canal from river Sutlaj to inundate the trench and irrigate gardens around the town. Wide and airy tunnels linked the royal residential quarters inside the fort to the adjoining gardens outside. There were 24 burgs (musketry holes) on the fortification wall, 24 mosques, 24 bavlis (ponds) and 24 wells in the town in its hay days. The trench, ponds and tunnels have been filled but at places the location of the trench can still be defined. Most of the wall has been razed. Two of the four massive gateways with pointed arches also exist though they are badly damaged and their wooden doors have vanished. The coats of cement have marred the architectural importance of the gateways.

Inside the walled city that is a vital living part of Dipalpur, dismayed, I looked around me and thought that I have entered a big and confused jungle of houses. The remains of once magnificent buildings of olden period adorned with beautiful wood engravings serve to relive the dullness of the domestic architecture. The whole area has a homogeneous urban texture that has survived for centuries. The narrow and winding streets lined by redeveloped and shoddily built new houses give Dipalpur a mean and gloomy look. The old character of the city is eroding due to erection of new structures and unsuitable repairs.

Besides doors with decorated latches, jharokas, bay windows and cut brick works still surviving despite all odds, the most noticeable feature inside the old Dipalpur, which reminds of the past prominence, is the monastery of Lal Jas Raj, a guru much venerated by the Hindus. As per the famous legend, Lal Jas Raj was young son of Raja Dipa Chand, the founder of Dipalpur. The boy sank in the earth due to the curse of his stepmother Rani Dholran. Raja Dipa Chand constructed this monastery in the memory of his son. Today the dilapidated and empty chamber stands infested with bats and rats. Termite is eating its woodwork. I could not open the doors to the chamber because they are jammed and a stairway is serving as storage for dried dung cakes of the neighbors. The structure is crumbling. "There is nothing inside. There used to be a grand annual 'mela' here.

Hindus have been coming here to shave off the heads of their sons till after the partition but no body comes anymore," informed the residents who had gathered around me. Another noticeable building inside old Dipalpur, which reminds of the bygone glory, is a saray (inn) near the monastery of Lal Jas Raj. The architects of the period when this inn was raised were familiar with use of space, element of design and response to climate. It was a spacious building with airy rooms on four sides, a big courtyard in the center and four arched entrances. The inn used to be functional and firm but now it is dark and dirty. It has been divided and subdivided by its occupants so many times that you cannot make out its original shape. Even the verandas have been clogged to create additional rooms. The best would have been if the inn remained in public use. This does not seem possible now.

Muslim saints have been coming to this area to spread the light of Islam. Hazrat Bahawal Haq commonly known as Bahawal Sher Qalandar came from Baghdad and settled in village Patharwall near Dipalpur. The saint constructed a Hujra (living room) and a mosque outside the village. His grandson Hazrat Shah Muqeem continued his mission. The village came to be known as Hujra Shah Muqeem. This is the place that is mentioned in famous Punjabi folk love story 'Mirza Saheban'. Though there is no historical evidence that Jati Saheban came here and prayed: "Sunjian howan gallian which Mirza yar phere" (the streets should be deserted where my lover Mirza should roam about).

Mughal king Akbar along with his son Saleem and royal entourage stayed in Dipalpur when he came to pay homage to saint Hazrat Farid Ghang Shakar in Pakpattan in 1578. Akbar named the corridor as 'Bari Doad' by combining the syllables of the names of two rivers (Beas and Ravi) that bounded the belt. Baba Guru Nanak also stayed in Dipalpur for sometime. A completely ruined Gurdawara (temple) reminds of the place where Guru Nanak stayed.

Situated on the old bank of river Beas, Dipalpur started expanding and spilling out of fortification long ago. It was declared as notified area in 1949, which has been raised to the status of Municipal Committee. Now it is a typical Pakistani market town with all the hazards of urbanization: congestion, mixed traffic, encroachments, potholed roads and piles of domestic waste. Municipal Committee does not seem to notice the plight of the residents, particularly those living in the old portion of the city. The area is very fertile and ideally suited for livestock and agro industries.

Sadly, our Archaeology Department is neither very keen to ‘discover the missing links of human evolution in this area nor in preservation of bits and pieces of history lying under the layers of time. Challenge of restoring the ancient Dipalpur to its old magnificence might be too much, but the experts could carry out a survey to record the places having essential, historic, social and architectural value.
Historically Wrapped and Simply Romantic
When one has seen one Punjabi Town, one has seen them all, except Malka Hans. Now long forgotten by most people, a historic little town - serene, tranquil, pollution free - was once an abode of Waris Shah, who stayed here and composed universal romance Heer Ranjha. Legend has it that Malik Muhammad (alia Malka) - a member of Hans tribe founded the town some 700 years ago. Hans became powerful when Mughal King Alamgir conferred a vast land around Malka Hans on Sheikh Qutab Hans. In 1764, Muhammad Azam who was the descendants of Qutab Hans became head of the clan and made himself independent.

Ran Singh Nakka later treacherously took Muhammad Azam prisoner where he died in confinement. A great Punjabi poet, Waris Shah was born in Jandiala Sher Khan (district Shekhupura) in 1719. After completing his education in Kasur (district Lahore), he shifted his residence to village Malka Hans. Here he resided in a small hujra (living room) adjacent to the historic mosque that was constructed by Hans in 1340. Hafiz Ghulam Murtaza commonly known as Mian Wadda was the trustee of the mosque and used to lead the prayer when Waris Shah came here. In the absence of Mian Wadda, Waris Shah performed the duty of leading the prayer congregations.

It is this 'Hujra Waris Shah Da' that I had come to see in Malka Hans. Waris Shah had composed an illustrious Punjabi folk romance sitting in this hujra. The underground 8 x 6 feet hujra where the poet lived is still there though devoid of any furniture or things that could be related to Waris Shah to bring back the memory of the poet. Only sign showing that Waris Shah had been living here is a crudely written plaque with sketchy details about the poet. The classic work of Waris Shah - Shakespeare of Punjabi language - echoes in the countryside and youth and elders sing with joy. One can find a number of folk vocalists singing Heer Waris Shah around the vast expanses of Punjab and other parts of the Subcontinent where Punjabi language is used. Many people remember major portions of his work by heart. Poetry of Waris Shah is written in easy language and can be understood by anyone with average language skills. The couplets are used as idioms and phrases in day-to-day life. The ancient mosque, now known as Mosque Waris Shah, with three green color domes and a hujra are venerated by literary figures, curiously conscious and devoted faithful.

I could not see the book (Heer Waris Shah) written in longhand by the poet himself despite the best effort. There is another small room in the mosque premises with nameplate that reads, "Library Waris Shah" but that too was closed and the key could not be procured because "it had been misplaced". The monument is in the care and custody of Anjuman-e- Warisia (Registered). It is not being given the attention it deserves. The residents of this town celebrate Annual Jashne Waris when romantic and mystic poetry of Waris Shah is sung by folk singers. I was thinking as to how the plight of this priceless heritage could be brought to the echelons of power. The town is located 30 minutes drive away from Sahiwal and has a Town Committee, which has not been able to do any thing other than brick lining in some of the dusty and dark streets in town. Conservation of legendary national heritage we are poised to loose forever is a difficult task for the civic body with little resources.

Exploring this sleepy little agricultural town, you can also see the dilapidated relics of Parnami temple that used to be one of the central ashram of Parnami faction of Hindus. Mahant Darbara Singh had constructed palace like five-story majestic building of the temple over 200 year ago. Dust of ages has settled in deep layers on the pedestal where Smadhi of Dya Ram - the founder of Parnami sect used to rest in the main chamber of the temple. "Large number of Hindus had been visiting here before partition and there use to be a big annual mela in the month of Chetar," informed a villager who is using this place as a house. "I am paying rent to Auqaf for living in this Khandar," he complained a little wistfully.

This grand monument of the past with sold masonry and ornate designs wrought by artisans and artists centuries ago was one of the fine specimens of Hindu architecture. Termite is eating Wood but exquisite quality of woodwork on windows, doors and murals on the battered walls can still be seen. The think red bricks excavated from this monument have been used in houses in the town. And, sadly, the temple cannot be defined in the images. Auqaf does not appear to have any idea about what to do with these splendid remains of the Hindu architectural legacy, except perhaps recovering the rent from the tenants. "Last time Auqaf got the place cleaned was when Indian Minister Hari Karishan Bhagat and Ambassador De Sharma visited the temple", informed the present occupant of the edifice. Legend has it that there was a tunnel from this temple to Pakpattan, though I could not locate the opening of the tunnel because huge quantity of rubble lying everywhere in the courtyard.

On the way back, I along with my friends had dinner break at a roadside-eating joint known as 'Pak Afghan Rohani Baba Hotel' near Yousaf Wala (Sahiwal). Sitting on ground, we had their famous mutton dish specially made in lamb fat. That reminded me of a small but famous eating joint in Saranan near Quetta.
Pleased in Pakpattan
Pakpattan - the name is enough to start the travelers, cautiously curious and devoted faithful dreaming. Already the magic words like sultans and saints are stirring in the head. Let your gaze slip over the dhaki - original citadel of Pakpattan - and the town will suddenly appear. The antiquity is its own message: the town is heritage, and heritage permeates the town.
Enter the once walled inner-city through one of the existing gates and you will find yourself in archetypal form of an ancient town - crooked and narrow streets, dense housing, intricate woodwork on Jharokas, bay windows and doors. So many historic cities have developed losing much of their original character in the process during modern times, but Pakpattan has survived remarkably in tact. It is the entire urban fabric of the place that is historic. Though, the major portion of the fortification wall has disappeared. At places, the wall has even been utilized as a part of the residences. Four gates (Shahedi, Rehimun, Abu and Mori) have survived out of six but they are all crumbling. Now extensive suburbs stretch from the foot of the wall all around. Thin red bricks from centuries old wall are seen used in the new houses all over the town. The portion of the settlement that sits on the mound can be compared with walled part of Multan City.

The remains of peripheral wall with ancient mystique define the inner portion that is totally pedestrian, vehicular traffic and modern development contained out of the wall. Homes have also retained their essential trait despite renovations to make them comfortable for modern living or to create additional space for more families. You can see the mythical woodwork, murals as well as tiled facades and colorful patterns in old havelies.

General Alexander Cunningham has recognized Pakpattan, anciently known as Ajudhan, as a town that appears in the work of Hellenic historians and other classic writers under the names of Ohydrakae, Sydrakae, Sudraykae and or Hydaekae. Two strategic roads of the past - one from Dera Ghazi Khan and other from Dera Ismail Khan - used to meet here. Great conquerors like Mahmud Ghaznavi, Taimur and traveler like Ibn-e-Batuta crossed Sutlaj from Pakpattan that had been principal ferry on River Sutlaj for centuries.

Medieval history of the town started when Amir Subuktagin subdued Pakpattan in 980 (AD) followed by Ibrahim Ghaznavi in 1080. Even today, the thought that Taimur during his invasion in 1398 spared the lives of those who had not fled the place, out of respect for the shrine of saint Baba Farid, inspire reverence.

The soul of the city is famous saint Farid-ud-Din Masud Ganj Shakar commonly known as Baba Farid. The saint was born in a village Kothewal (near Multan) in 1173 in a family that had migrated from Afghanistan. Saint, scholar and poet, Baba Farid traveled to Khurasan, Kirman, Badakhshan, Baghdad, Mecca Muazzma, Madina Munawara, Kufa, Basra, Damascus, Nishapur, Bukhara, Dehli and Multan before he finally settled in Pakpattan. Here he spent his life in spreading the light of divine Islam. It was due to the religious services and personal example of the saint that Islam spread in this part of the Subcontinent and many people including Hindu Jogi Birnath along with his followers came into the folds of Islam. The saint died in 1265 and his shrine was constructed by Khwaja Nizam ud Din Auleya in 1267.

Splendors of the 'Farid Complex' fire the imagination. The shrine - simple and destitute of ornament - stands next to the bigger shrine of his grandson Ala ud Din Mouj Darya, which was built by Sultan Muhammad Tughlaq. The main chamber of the shrine of Baba Farid has two doors - one in the East is called Noori Darwaza and the other in South in famous Baheshti Darwaza. Besides the principal grave of the saint, there is another grave in the chamber where his son Badr ud Din Suleman is buried. The ample, pure and unadorned architecture is very inspiring. Urs of the saint is celebrated in the month of Muharram but large of devotes stream into the shrine everyday. You can also see Qawwal groups performing and malangs falling in state of trance mostly on Thursdays.

Both the principal shrines are in good condition but the adjoining ancient mosque has decayed. Auqaf is constructing a new mosque nearby as a part of Farid Complex. Besides the shrines of Baba Farid and Mouj Darya, there are over twenty shrines of saintly persons in the town. Most eminent out of these is the shrine of Baba Aziz Makki.

There is a whole different world outside the shrine parameters. Cubbyhole shops selling deathbed spreads, flowers, big bangles and sweets (for niaz) known as Makhane and eating joints are lined up in both the streets leading to the shrine. Business in the streets is thriving because devotees 'must' take something home from the shrine. Sleazy sounding and persistent beggars flock around devotees heading for the shrine. People are seen distributing free food: cooked food is available for sale in large quantity round the clock. A philanthropist from Karachi is running a separate Lunger Khana at his own expense since 1995. Bustling with activity, the place seems to have its own culture.

How the name Ajudhan was changed to Pakpattan? It is a fact that name Pakpattan (meaning pure ferry) distinguished due to the home and last resting-place of Baba Farid. According to a local lore, Mughal King Akbar on the eve of his visit to the shrine to pay homage to the saint declared Pakpattan as an official name of the town. The thought that so many people including Ibn-e-Batuta, Guru Nanik Dev Jee and Waris Shah had visited the shrine evokes awe and aura of eternity.

Wandering about in the older part of town near the relics of Kacha Burj - defensive tower that was erected by Haibat Khan during the rule of Sher Shah Suri, you can think about the strategic importance of this town in the bygone era. But, during Mughal time when danger from the North reduced, the town lost its defensive significance.

Pakpattan was first declared district headquarters in 1849 when British rule established in the Subcontinent. The headquarters were later moved to Gugera in 1852 and then to Sahiwal in 1856. British also instituted Pakpattan Municipal Committee in 1868. Kasur-Lodhran section of Railway line was laid in 1910 and Pakpattan became an important station on the Railway map because of railway divisional headquarters and loco sheds. Though this section of railway line was torn apart and sent to Mesopotamia during Second World War and the town could not prosper as an agricultural market in those days. On July 1, 1990, Pakpattan was again declared district headquarters. This became the only district of the country without any tehsil until Arifwala tehsil was included in the district in 1995. In order to preserve the bits and pieces of history lying under the layers of time, the experts could carry out a survey to record the places having essential significance. The living heritage should be declared as 'protected area' _ the concept that presently is not there in Pakistan.
Heritage Village
An old, sleepy and tranquil village Satghara lies about 80 kilometers from Lahore (20 minutes drive away from Okara) in the quiet backwaters of the Punjab. The coins found at Satghara prove that the place was inhabited at the time of the Kushan dynasty. The rule of Kushans was one of the most decisive periods in the history of the Subcontinent. At the height in the second century (A.D.), Kushans ruled from Oxus to Ganges and yet their influence spread beyond even these frontiers. On the southern bank of the Ravi, it is a typical Pakistani village where farmers live like rustics in the face of urban attractions. Though off the beaten track, it has never been out of limelight. Besides heritage conscious travelers from all over the world, Baloch leaders and contemporary historians visit the hamlet. Reasons: it is a "Tukia Nawab Chakar Ki" - last resting-place of Mir Chakar Rind. Part of our history is buried here.

As per one account, Mir Chakar Rind came to this village with seven families, hence the name. Another legend has it that the village was named Satghara because it was destroyed seven times by floods. Shah Abul Mo'ali, descendant of sixteenth century saint Muhammad Ibrahim Daud-e-Sani Bandgi in his book 'Maqamat-e-Daudi' maintains that Satghara was known by the same name even before the arrival of Mir Chakar Rind. In Baloch history, the sixteenth century was a very eventful period. Baloch fought series of wars amongst themselves. The result of these tribal conflicts not only caused large-scale bloodshed but also resulted in their mass migrations to the Punjab, Sindh and Gujrat (India).

One such immigrant, center of Balochi love lore and war ballad, Mir Chakar Rind is regarded as one of the great Baloch heroes. Born in 1468, Mir Chakar Rind lived in Sevi (modern time Sibbi) in hills of Balochistan and became the head of Rind tribe after his father Shiahak died. A natural leader and warrior, Mir Chakar Rind was a man with resolute determination. In 1496, Mir Chakar traveled to Hirat (Afghanistan) to muster support from Sultan Shah Hussain. To prove his personal valor, he was made to fight a mad elephant and ride a tough horse in Hirat. He succeeded in all these tests though could not get the support. A class of Balochs even regards him having been invested with saintly virtues and mystic powers.

Over a trifling mater - a Lashari youth butchered and roasted the kid-kamels - Mir Chakar and Gwaharam, head of the Lashari tribe went to war. Thousands of Rinds and Lasharis were killed in this war, and ballads that still echo in hills of Balochistan and are part of Baloch oral literature, commemorate the personal gallantry of the two heroes. After 'the thirty year war' against Lasharis, he left Balochistan and came to live in the Punjab in 1518." Why Chakar-e-Azam, as he was commonly known, preferred to settle in the central Punjab, far away from Sibbi is not known. Once at Satghara, he constructed a fortification wall around the village and burj (watchtowers) in 15 squares Kilometers area encircling the fort for early warning against impending dangers. In case of any threat, the guard on the watchtower would light up fire, which will be spotted by the other guards and the news would be communicated all around without delay. From one crumbling watchtower, I could see miles of waving cops in all directions.

Settled in Satghara, Mir Chakar Rind became a regional force to recon with. He was respected (and feared) in the area. Afghan King Sher Shah Suri approached Mir Chakar Rind to join hands with him and help him consolidate his gains. Mir Chakar Rind appreciated the situation and not only wisely refused to help Sher Shah Suri but also managed to elude Afghan armies. Instead, his forces under the able command of his son Mir Shahdad joined Humayun when after a long exile in Persia Mughal emperor came back, recaptured Delhi and ousted Afghan Suris in 1556. Emperor Humayun as a reward conferred a vast Jagir (including horses and slaves) upon him. Mir Chakar ruled this chieftaincy till he died at the ripe age in 1565. It is the tomb and fort of Mir Chakar Rind - or whatever is left of them - that curiously conscious and those interested in history come to see at Satghara. The fort is large. Actually the wall once encircled the entire village. Two gateways with flat bands and pointed arches still survive though badly damaged due to ravages of time. The wooden door panels have disappeared. With growth in population, the village has grown and spilled out of encircling wall long ago. Standing at a vantage point one can still feel antiquity permeating from the cluster of mud and brick houses inside the fortification wall. In some houses, one can see mythological and thematic murals of the Hindu period. On the periphery, the classical mud houses look nice.

Constructed of narrow red bricks, used in upright courses to ensure additional strength, the wall is 25 feet high and three feet thick. Some of its salient portions exist between the tomb and the first gateway. Despite the salinity and cracks creeping up the wall, the architectural feast seems to re-echo to the past memories. Beside one of the doorways, a sign has been posted announcing that the Archaeology Department protects the site. How seriously the 'warning sign' has been taken by the villagers can be seen all over the village. Red thin bricks excavated from the centuries old monument are found used in many spanking new houses in the village. At places the villagers have utilized the fortification wall as part of their houses. Major portion of the wall and what would have been the living quarters of the family of Mir Chakar Rind have been lost. The courtyard of the tomb has shrunk due to encroachments and presently it is being used as Shamlat deh (community center) for keeping the animals and elders to sit under the shadow of big pipal tree during lazy summer afternoons.

The followers who had accompanied Mir Chakar Rind to Satghara built the tomb after death of the hero. Today there is not a single Baloch living in the village. The neglected tomb is dilapidated and the surviving history is falling fast into decay. The main chamber of the once majestic and imposing tomb is octagonal in plan. The roof, decorative work and plaster have vanished. Cracks have snaked in all direction on the walls. The rainy water gathers in the roofless main chamber and stays there till sun dries it. The water is destroying the foundations of the crumbling edifice, which is gradually sinking in ground. There are seven rough mud graves inside the chamber. A small tablet distinguishes the central grave. It reads: Akhari Aaramgah, Mir Chakar (Khan) Rind, Satghara, Okara, Munjanib Yong Baloch Welfare Society, Ravi Road, Lahore. Even the name of the great hero on the tablet is not written correctly - having word Khan inserted quite unnecessarily. Similarly, the large plaque placed by the Archaeology Department needs improvement. The tomb was desecrated and its roof demolished by Maharaja Ranjit Singh who, on his way to Multan to fight against Nawab Muzafar, had stayed in Satghara about 150 years ago. It has never been repaired ever since. Governments, Archaeology Departments, visitors from all walks of life, police (there is a police station in the village), district administration, locals or Balochs, no body seems to be concerned about the state of this important monument.

If one wants to absorb the sense of history, Satghara is a place to visit. One has to possess a sensibility shaped in granite not to be moved by the relics of past age, the monument of departed greatness belonging to a celebrated hero who now rests helpless and neglected in this silent place, far removed from the noisy haunts of men. The first impact that this monument gives is an emotional one, for it is a sign of identity and a part of our history. It also has architectural, documentary, spiritual and symbolic values. In the vicinity, a few van (salvadora) trees, may be as old as the relics, stand witness to the bygone era. Swooping and cooing wild fowls and running squirrels also testify to the continuity of the human habitation in the area. Though not mentioned in the touristy literature, yet travelers who come to see the ruins in Harrappa (about 40 kilometers from Satghara) make to this monument village: to study the history, architecture and culture of the time when the monuments were built. The remains of the monument have to be preserved and saved from ruination, a danger they are facing at present.

As I drove back on a single way metallic road, plied mainly by animal transport and milkmen on the motorbikes, I could not help thinking: Can the plight of the priceless site be brought to the echelons of power? Can some national or international agency be moved to act and save the place for coming generations? We owe them this!
Shifts in Sher
          Dr Norbert Pintsch meets CM Punjab        
Prof Dr Norbert Pintsch, a senior German volunteer, called on the Chief Minister Punjab Mr Shahbaz Sharif on 30 September 2016 and discussed wide range of matters relating improvements in village Thatta Ghulamka Dheroka and how the government of Punjab can help the Project in the village being run with the support of German volunteers. Dr Norbert also apprised the CM about what has been happening in the village for last 25 years since the start of the Project.

The meeting with CM Punjab has triggered a good amount of activities and a lot seems to be happening in the Village besides visit of high ranking officials of Okara District.

In addition (and as a result of CM’s interest in the Dolls Village Project), Dr Norbert Pintsch is going to meet Energy Department Punjab on 3 October where solarization/electrification of Basic Health Unit and street lighting in the village will be discussed.

On 4 October 2016, a meeting is scheduled with DCO, Okara for discussion on cleanliness of buffalo pond, drainage system, clean drinking water project, maintenance of the approach road,  and posting of more staff in village schools and Basic Health Unit.

Later on 5 October 2016, Dr Norbert Pintsch is also due to speak as guest speaker in Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan before he leaves for Germany.

          An Important Message from David and Laura; We Need Your Help to Save David's Life:        
Chicken_mush (5 of 18)

A good meal can lift the spirit, and I think we can all agree a great meal can make you feel much better, mentally and physically. But food can't fix everything.

For the first time in a long time, we dusted off an old recipe (a chicken and noodle dish we fondly dubbed ‘Chicken Mush’). I needed some comfort. This is why.

Earlier this year in January, David went to the doctor for a headache that wouldn’t go away. They saw that his blood pressure was alarmingly high, so they put him on two medications and ordered blood tests. The results were shocking: Chronic Kidney Disease, Stage 5 (AKA “End Stage”). Somehow David’s kidneys had been damaged so severely they were struggling to operate at 7% of normal capacity.

Meaning? Do not pass go. Do not collect $200. Go directly to a transplant program and needing a matching donor to prevent imminent dialysis this year, which is more and more likely as time passes.

We’re trying to delay the horrors and health risks of hemodialysis by managing a strict renal diet for David, so our blog posts are about to get real weird. Want to know the secrets of making Brazilian Beiju flatbread? You will.

But like I said, food can’t fix everything.

If you want to help us, there are several ways

First, anyone can help us by spreading the word about our situation. The more awareness we have, the better the chance of finding a matching kidney.

If you are open to exploring donation, here is detailed information about kidney transplants and donation. But, there are some important questions about donation that I will answer right away.

“Will I be just as healthy after I donate one of my kidneys?”

Yes! After donation your other kidney will increase in size and functionality to compensate. You will be able to return to all your normal exercise routines and physical activities after the recovery period.

“Is the donation process safe?”

Yes! Although it is a surgical procedure, the transplant team will rigorously qualify you before accepting a donation. They will never accept a donation that puts the donor at risk.

“Will the donation process be expensive?”

No! The recipient’s insurance pays for almost all costs. The only things you would have to cover is any needed basic health exams and time off work to recover.

We need you!

If David goes on dialysis, rather than a transplant, we’re looking at an average life expectancy of only 10 years, many of them hooked up to a machine of some sort. It’s an ugly thing to think about, but those are the facts. Kidney transplant is a treatment that can double his life expectancy while also greatly improving the quality of those years.

David’s exceptional transplant team is based out of U.C. Health, and he is registered there for anyone who is interested in the facts about donation. You can call his transplant coordinator, Janea Matherly, at 513-584-5573 or email her and she will be happy to take your information and walk you through a short questionnaire (also available here, can be faxed to 513-584-0881) to determine if you are a candidate. I am probably the best person to look to for any updates on David’s health. I will also be undergoing the donor testing process (I am not a match via blood type but there's another process I will be pursuing, explained below), so I should have answers to any questions or concerns that you might have. Ask away.

David's blood type is A, which mean positive or negative donors A or O could be a match. Even if you aren’t a match for David, there are programs that match donors up with other donors that could be, which actually means that your decision can start a reaction that saves the lives of multiple people! Think of it like a daisy chain. Except made out of squishy, squishy kidneys.

We’re in this together

This will be the hardest thing David and I have faced together yet. We are grateful to have access to exceptional doctors and support of family and friends. David is incredibly smart and is proactively managing his care, and I’m a force to be reckoned with when it comes to getting big things done. Still, I’d be lying if I told you that we were really ‘OK’ right now. We're both handling it a little differently.

This is David
This is me

Situations like this really put things in perspective. Life is short and sudden onset, unexplained illnesses like this can make it much shorter. I urge you to make the most of your own and be kind to who you can, where you can and when you can.

And if you've got the time, make someone who might need it some Chicken Mush. Except not for David, since he can’t eat it right now.

Chicken Mush Recipe

Very early in our relationship, David developed this recipe from what we happened to have in our pantry. It's inexpensive to make and extremely easy -- perfect for two people with student loans living in a small apartment with a dated kitchen.

Chicken_mush (14 of 18)


8 cups water
8 cubes chicken bouillon (or equivalent, you’re looking for about 800 mg sodium per cube)
1/2 cup dry Marsala wine
1/4 cup soy sauce
1 tsp parsley
1 tsp curry powder
1/2 tsp garlic powder
2 10 oz cans chicken meat (or leftover roast chicken if you have it)
1 lb (16 oz) extra wide egg noodles
1/4 cup extra virgin olive oil

  • Add cubes to water and bring to boil
  • Add wine, soy sauce, and spices
  • Make sure broth is well mixed, then add chicken meat with juice
  • After boil returns, add noodles and cook uncovered for 15 minutes
  • Halfway through cooking, add oil and stir noodles thoroughly
  • Enjoy or give to someone who needs it.

Chicken_mush (11 of 18)

This morning I opened my emails to find an email from Andy White and felt compelled to share what he said with you.   We all, no matter how well off, financially or emotionally, have a tendency to moan about what we don't have instead of being grateful for what we do have.  Andy's words have a great relevance to my work with Children in Distress and to your support of CID.  Here is what he wrote:-

Do you own a car? Only 8% of the world do, so that means 92% don't. And that means that whatever type of car you have, if you have one, you are privileged.  Do you enjoy clean, disease-free, running water from your kitchen tap? More than one billion people don't have access to clean drinking water, never mind a kitchen tap. That figure includes an estimated 400 million children - more than the entire population of the USA.  And, because unclean water is full of nasty stuff, it causes illness resulting in somewhere around 443 million school days being missed every year.

If you're like me, you don't like feeling hungry. But you probably don't have to put up with that feeling for longer than it takes you to find a snack, right? But around 800 million people won't eat anything at all today. Nothing at all. And about 300 million of those people will be children.  So is it any wonder that, every couple of seconds, someone dies from hunger?

Do you complain when the power gets cut or the internet goes down? I know I do.
But I have no right to complain. Approximately 1.6 billion people - that's about a quarter of the world's population - live without any electricity at all. Can you imagine life without electricity? I can't.
When you get passed over for a raise, or miss out on that bonus, it sucks. But what sucks more is that nearly half the world's population — that's more than 3 billion people — live on less than $2.50 a day. That's 3 billion people living on less than you and I may spend on a coffee.  And what about the 1.3 billion people who live in extreme poverty - less than $1.25 a day?

The contrasts between the 'haves' and the 'have nots' are stark.

Here's an example of that contrast: Americans spend $20 billion per year on ice-cream - yes, ice-cream - while around 800 million people worldwide don't have anything to eat at all, never mind a desert.  And I'm not beating on Americans - I am quite sure other countries could provide equally horrifying statistics - I just don't have them to hand.  And that $20 billion spent on ice-cream would go half way to raising the approximately $40 billion it would take to offer basic education, clean water and sanitation, reproductive health for women, and basic health and nutrition to every person in every developing country.

Look, I didn't mean to wreck your Sunday morning, but these things are worth thinking about.

And I've been thinking about them a lot recently. Not specifically the situations I just shared with you, but the way I view my own life in a world where, as I type these words, someone is starving to death, or drinking water that will kill them.  You see, we gauge our lives based on what we see around us - among our peer groups and in our neighbourhoods. And, we get sucked into an 'I need more than I have to be OK' mind-set.

But the problem with that mindset is that you lose sight of just how 'rich' you are.

You see, when you focus on what you don't have, you cast aside the blessing you already hold in your hand. And without an attitude of gratitude, you will never enjoy all that life wants to give you.  If your starting point is not gratitude, you will always be discontent. You will always be looking for more, striving, reaching, wanting.  I know how this works. Over the years, I have missed the fullness of so many blessings because I never paused to hold the gift that had been placed in my hand so that I could celebrate and enjoy it.
I still fall into that trap, but I'm working on cultivating an attitude of gratitude. And all those stark statistics I gave you remind me just how lucky I am to have what I do have, and how ungrateful I am to lament what I do not.

So what do you think about gratitude? Does it come easily to you or, like me, do you need to work on it? What do you do to make sure it's a part of your make up?

Powerful words huh?  They certainly set me thinking! I know that many of you are grateful for what you have; otherwise you wouldn't be helping CID to look after the children we care for and for that support I, and my colleagues both here in the UK and Romania are extremely GRATEFUL.  Please encourage more of your family and friends to be grateful for what they have and to show that gratitude by supporting those who are not so well off.  Thank you :)

Jane x

          Skill Set: How Does Your Garden Grow? Part 1 - Welcome to My Indoor Edible Paradise!        
hudson valley seed packets 

. . .with silver bells, and cockle shells. . .And pretty maids all in a row.

In Building Blocks of Intent (Pt. 1), we looked at the importance of developing or refining different skills in leading a life of intent. I refer to them as “life skills”— those directly related to meeting basic human needs, such as
  • food and nourishment
  • shelter
  • clothing
  • maintenance of basic health and well-being
With that in mind, one of my goals this year was to do just that. So, this past January I enrolled in an introductory gardening class through the New York Botanical Garden’s adult education program. I had always wanted to try my hand at gardening, but just never got around to doing it until now.

You’re probably wondering “January! Why would anyone take a gardening class then?? What kind of gardening could you possibly do in the dead of winter especially with all that snow we got…???” You are not alone! Everyone I told about the class asked these same questions. However, there’s quite a bit that goes into achieving the beautiful (or edible) end result that most people associate with gardening, and we spent the time covering fundamental theories and concepts such as
  • the basic parts of a plant how they function
  • soil health & structure
  • organic gardening techniques
  • pest control
  • basic garden tools
  • plant selection and care
  • propagation and pruning
  • general site considerations when planning your garden
all done from a nice, warm and cozy classroom!

Also, you may not realize it, but there's a life cycle to gardening, so there's always something to be done year round.  In fact, our final course assignment was to take what we learned and create a simple plan covering a year of maintenance and planning for the garden of our choice (you can see my final report here). The tail end of winter is a key time for indoor seed starting, so your plants will be ready to go into the ground come spring. Then of course, there’s the main growing season from spring, through the summer, and depending on what you’re growing, even into the fall. In the late fall it’s time to begin preparing your garden for winter…clearing out dead growth, sprucing up the beds and so on. Something else you may not know is that there are things you can plant in the late fall at the end of the season, also known as “cover crops” or “green manure” (e.g. ryegrass, winter rye, clovers, oats, buckwheat, etc), which help protect and prepare the soil for spring when the cycle begins anew! This provides ground cover that helps prevent soil erosion, replaces nutrients depleted during the growing season (e.g. nitrogen), and helps with weed suppression as well as pest control.

Unlike most of my classmates, I don’t currently have access to any outdoor gardening space (not even a terrace!), so I will be adapting what I learned for an indoor garden. Another challenge for me is that I live in a small apartment with limited space.

But, be those things as they may, I am starting with the picture on the left and intend to move towards the picture on the right!

indoor garden, before & after

And, after listening to a podcast by Erika Harris of Empathic Writer, during which she talked about her grandfather and his talent for turning his back yard into paradise (go to Episode 001: Say the Things You Want to Hear in the World and jump to the 00:03:09 to 00:03:30 mark), I was further inspired to create my own Indoor Edible Garden Paradise.

As described in my garden maintenance plan, my goals are modest. I plan to get started with some herbs and other edibles (cilantro, scallions and rainbow chard) suited to my particular site constraints.  I have some seeds I purchased from the Hudson Valley Seed Library. I originally bought them because the outer packets were so beautiful, never thinking to actually plant them, but now I figure “Why not!”

However, I also have a Plan B, just in case! I purchased a Burpee “Culinary Herb Garden All-in-One Kit”.  According to the package it includes “everything you need to grow 5 delicious herbs”

     > 5 seed packets – parsley, cilantro, chives, basil and oregano
     > 3 containers and a watering tray
     > growing pellets
     > instructions
     > recipes!

So, we’ll see how it goes and which approach works for me. I hope you’ll join me on this journey, and be inspired to try it yourself! If I can do it, I’m sure you can too!

Changing Your Intent

Get Skilled: What You Can Do Now!
  1. Pick a new life skill that you would like to learn whether it’s gardening, sewing, cooking, first aid, fishing, or whatever tickles your fancy. Your local weekly paper is an excellent resource for discovering workshops and classes that might be going on in your community.

  2. Tell us about what you've decided here or start a discussion on the With Intent Facebook or Google+ page.

          The “homecoming” rally serves no purpose to anyone except to stroke Nawaz Sharif’s ego        

Pakistan continues to be the playground for politicians. Fit or fat, fair or dark, politicians of all caste and creed continue to make a mockery of Pakistan and its people. What is this democracy they tout when the only choice they give to the people is themselves? As was evident from Imran Khan’s dharna and now Nawaz Sharif’s rally, our leaders seem to care more about touting their own horns and publicising their victimhood instead of helping the masses.

Nawaz started towards Lahore on Wednesday afternoon, as if he were a king receiving an amicable send off from a grateful nation instead of a prime minister deposed on corruption charges. There were grand announcements of a march to Lahore under the shadow of a fawning public. Unfortunately, various media sources reported that the rally failed to get an optimal number of activists. Nawaz was supposed to lead the crowds to D-Chowk and deliver a rousing speech; however, the speech was cancelled due to ‘security’ reasons. Again, the real reason purported by various media sources was a lack of crowds.

Even though the Pakistan Muslim League-Nawaz (PML-N) failed to achieve in crowd numbers, they were quite successful in inconveniencing the people of Islamabad and Rawalpindi. What they claim as a gain of political capital is actually a drain of national capital. The newly minted Interior Minister Ahsan Iqbal is leading the rally to ‘monitor security’. Yes, ensuring security in the country is one of his jobs as interior minister, but why does he actually have to lead a former prime minister’s rally? A blast happened in Lahore, there is unrest in the tribal areas, the country is battling power outages, poverty and a negative stigma, yet priority is given to a political rally that serves no purpose to anyone except to stroke Nawaz’s ego? The rally is supposed to take four to six days to get to Lahore – will our interior minister be absent for his actual duties during this entire period?

There is a mobile health unit attached with this rally. What about all the cities and villages in Pakistan that lack basic health care services? What about the pathetic conditions of hospitals in Lahore, which is supposed to be a strong hold for PML-N? When the recent oil spill tragedy occurred in Bhawalpur, the city came up woefully lacking in burn units. Bhawalpur is a major commercial hub of Punjab, Pakistan’s most profitable province and one that has been ruled by the PML-N for decades. Yet, the priority has been given to provide a serviceable mobile health unit to Nawaz’s rally. This clearly proves whose benefit and safety is actually important – not the people, but an ousted, corrupt politician.

Containers in the Pakistani political landscape play the same role as Hollywood vanity vans. Apart from import and export activities, they are most commonly used to block roads to limit street protests or to transport politicians. The container Nawaz is travelling in is bulletproof. Imran and Tahirul Qadri famously gave rousing speeches at their dharnas outside their containers and stayed inside them at all other times. Unlike vanity vans, containers are ugly, huge and difficult to move. One major reason for the rally moving at such a slow pace is because the PML-N plans to move this container from Islamabad to Raiwind. If the streets in Islamabad are choked right now, I shudder to think of the traffic jams they will cause on GT Road.

To hear the PML-N leadership talk about the rally, they are positioning it as a ‘homecoming’ rally for Nawaz. When former president Barack Obama finished his second term in the White House, he quietly packed up and left. There was no ‘homecoming’ rally conducted in his honour and neither was there any fuss within his political party, the Democrats. Secondly, neither Obama nor his siblings/offspring/parents were appointed as president for life of either the Democratic Party or the US.

What’s surprising though is how confidently Nawaz led this rally, considering how the Election Commission of Pakistan (ECP) de-notified him a couple of days ago. Since this notice rendered him ineligible to act as PML-N’s president, should he have been allowed to lead the rally as the leader of the party? Ethically, no, but in Pakistan, the powerful can ignore constitutional verdicts and get away with everything. That being said, it will be difficult for Nawaz to give up his position, but legally, he has no choice. The party needs to hold intra-party elections as soon as possible to elect a new head for the party. For now, though, according to the majority vote in the party, Shehbaz Sharif will step in as his replacement. This works out perfectly for Nawaz, since he can’t afford the party being run by anyone other than a Sharif.

Pakistan is on the cusp of turning 70. The country has seen more than its fair share of disasters and tragedies, be it natural, terrorist-related or political. Yet the country seems to drag on – just like Nawaz’s container through the streets of Islamabad. Like all other disasters, we will survive this as well. Though we should try to break this habit and either elect leaders that care about the country rather than themselves or at least dismiss leaders through the democratic process.

          â€œI explored, I understood, and I chose”        

“I explored, I understood, and I chose.”

These are the words of two women I met in India in February 2014. Neha and Ashrit both live in villages in the Hardoi district of Uttar Pradesh, India. Neha lives with her husband and two children—Chandan who is four and 18-month-old Naitik. I was on a trip for World Vision and visited several homes.

At Neha’s house, we talked about being a mother and the pleasure of taking care of our families. There was a brief silence and then she burst out, “I want to stop, giving birth. I want no more than two children. I think this will make me live longer and stronger and help my family’s financial situation, if I have more time to go out and sell some food.”

News of women dying during pregnancy worried her, and Neha told me she had seen this happen quite a few times in her village. Her concern led me to talk about family health, timing and spacing of pregnancies, and even limiting of births. Of course I had to gently let her know that none of what I said could be possible unless she or her husband used a modern method of family planning of her choice. We talked and talked for about 30 minutes. She needed to discuss the idea of seeking family planning services with her husband. I told her that it was best to have a dialogue and together discuss the benefits they both can get from using a modern method of family planning.

In Uttar Pradesh, more than 60 percent of the population live in rural areas, where access to even basic health services can be limited. The unmet need for family planning in Uttar Pradesh, the most populous state in India, is 21.2 percent (NFHS-3 2005-2006). That means that women who want to delay (or space pregnancies) or stop childbearing (limit the number of children they have) are not using a form of contraception for various reasons.

The data also informs us that 12.1 percent want to stop having more children (limiting) and 9.1 percent want to space their pregnancies. Globally, it is estimated that the deaths of 1.8 million children under five could be prevented annually if pregnancies were spaced at healthy intervals.

Healthy Timing and Spacing of Pregnancy—Key messages:

  • Delay your first pregnancy until you are at least 18 years old
  • Wait at least 2 years after one pregnancy before trying for another
  • Wait 6 months after a miscarriage before trying for another pregnancy
  • Limit pregnancies to a mother’s healthiest years, ages 18-34

Spacing pregnancies by three years would prevent one in four child deaths and prevent one in three maternal deaths and would reduce childhood stunting by 50 percent. The window of opportunity for improving nutrition is the first 1,000 days, from conception through the first two years of life, also giving a mother and baby time to breastfeed.

Neha found an ally in a Peer Educator, a community volunteer trained by World Vision in counseling skills, messaging on the importance of healthy timing and spacing of pregnancies and family planning (HTSP/FP), and the link to better maternal and child health. The Peer Educator would visit Neha when her husband was at home, and provide knowledge on maternal and child health and family planning services. On one of these visits, Neha and her husband received counseling on the range of modern family planning methods offered by the Ministry of Health. With this knowledge, she and her husband made a life-changing decision and chose sterilization, a permanent method of family planning. Neha had her procedure in January 2015.

Ashrit lives with her husband and 8-month-old daughter, Chandani. Her story is slightly different. When Ashrit got married, she wanted to wait a few years before getting pregnant, but family pressure overcame her wishes.

She often partook in street plays (Nukkad Natak) in her village, organized in conjunction with village leaders, and one day the topic was on healthy timing and spacing of pregnancies and family planning. Soon after, Ashrit told me that she and her husband and family members began receiving the same messages by a community health worker—who was also trained by World Vision—during home visits. After the fifth visit, she told her husband that she wanted to use a temporary method of family planning to enable them to space the next pregnancy until Chandani was at least three years old. In November 2014, both she and her husband went to the clinic where she received a method of her choosing.

Now, with bright eyes, Neha and Ashrit say with confidence that they can and will ensure proper care and education for their children.

Through multiple social and behavior change strategies, World Vision is creating a movement of change and awareness about HTSP and FP. In addition, we are using a Citizen Voice and Action approach, which is our social accountability strategy to train communities to assess community services, discuss findings with the government leaders, and work together to make joint action plans on how citizens and government can work together to improve family planning and maternal and child health services.

Susan Otchere is currently the Project Director of the mobilizing for maternal and neonatal health through birthspacing and advocacy (MOMENT) project at World Vision. Nurse-Midwife, MCH, and FP/RH expert.

Learn more about our impact on global health! We focus on child and maternal health, using basic medicines, supplies, and interventions to prevent and treat illnesses at the community level.

Join us in helping to save the most vulnerable lives. Donate today to support our Maternal and Child Health programs.

“I explored, I understood, and I chose” | World Vision Blog

A World Vision trained Peer Educator counsels a family in India. (Photo: 2015 Max Greenstein/World Vision)

Families around the world that make a plan to space out their pregnancies improve the health of both the mothers and children.

Today on International Day of Families, meet two moms in India who chose the best plans for their families to help ensure productive futures for their kids!


          Kinky Health Care        
How should health care be reformed? Well, the Kinky Economist has a plan that provides for both universal health care and the best damn health care that money can buy. The first major component is government provided health care available to anyone. This public plan would be modeled on the VA system where the government owns the hospitals and the doctors and nurses are employees of the government, so members would not be able to choose their own doctor. If you want to choose your own doctor, pay for it yourself (or buy your own insurance). There is no right to choose your own doctor.

The plan would focus on preventative care where annual check-ups are not only free, but you could get paid for a healthy lifestyle. So much of our health care costs, especially diabetes, heart disease, and respiratory problems, are driven by behaviors such as obesity, inactivity, and smoking. By focusing on wellness, these costs can be avoided (although healthier lifestyles do result in higher costs due to increased life expectancy and chronic diseases in old age).

Chronic and catastrophic health care would be rationed by Quality Adjusted Life Years (QALYs). For instance, the government may pay up to $40,000 for treatment that extends a patients life by one year, so the cost per QALY would be $40,000. Yes, health care will be rationed -- it is already rationed. Every scarce resource is rationed. If you don't want the plug pulled on Grandma. then pay for her health care. You shouldn't demand that other people to pick up the tab if you're not willing to pay the costs. If QALYs are used to ration health care, then how much are we willing to pay to save a life? More accurately, how much are we willing to make someone else pay to save a stranger's life? The budget for health care must be limited to a percentage of the total government budget. Once a fixed dollar value has been created, the cost per QALY will depend on how many people are in the government plan and how much health care they need. The government plan is meant for the poor and the sick, not the healthy and the wealthy. If more people get their own insurance, then the available funds can be spread among fewer participants resulting in higher costs per QALY. The plan can also accept contributions from donors that would increase the cost per QALY.Another focus of the plan is positive externalities of health care. The plan could require patients to be immunized resulting in a reduced likelihood that other people will get sick. The plan could strongly encourage organ donation to help save other lives. The plan could be used for research on new medical techniques and drugs. All of these characteristics result in social benefits.

Another focus of the plan is cost containment. Treatments would be based on comparative effectiveness so that costly, ineffective treatments are avoided. Medical malpractice costs would be eliminated or at least drastically reduced by not allowing patients to sue or instituting a program to resolve these disputes. Generic drugs would be prescribed instead of brand names in order to lower pharmaceutical costs. The plan would also use it's size to negotiate better terms for prescription drugs, medical equipment, and other purchases.

There would also be a greater reliance on medical personnel other than doctors such as Physician Assistants and Nurse Practitioners. Additionally, employment in the system could be worked into programs for medical and nursing schools. For example, tuition is free at military academies such as West Point, but students are required to give four years of duty after graduation. The GI Bill will pay for college for soldiers after they leave the service. The federal government could pay for medical school with a requirement that the doctors work in the system after graduation.

The public plan is not for everyone and most Americans can and should get their own insurance, just as they do today. However, the health care system does have flaws and room for improvements. The primary downfall of the plans that seem to be bandied about is the insistance on a single level of health care resulting in either reduced levels of care and/or higher costs. By recognizing that everyone deserves basic health care but not necessarily Cadillac care, I believe that the KinkyCare framework has the best potential to improve health care coverage and results.
          Kinky Health Insurance Reform        
In addition to a public plan that covers the basic health care needs of everyone and anyone, Kinky Care also slaps the insurance industry upside the head and directs them back to the risk-sharing purpose of insurance. Although I am opposed to the reforms that turn the insurance industry into a cost-sharing bastard child, the insurance industry is in serious need of reform.

Critics point to insurance companies refusal to cover pre-existing conditions as a problem, but I am fine with the insurance company refusing to insure pre-existing conditions. However, I am opposed to denying legitimate claims in order to cut costs. The denial of claims or cancellation of insurance after a claim is made is referred to as rescission. Rescissions are not necessarily evil because they does have a proper role in combating fraud. If an applicant lies about a pre-existing condition and then makes a claim resulting from that pre-existing condition, then a denial of claim and rescission is proper. Combating fraud helps to hold down the cost of honest customers and the right to rescind a policy is cheaper than requiring a verifiable, complete medical history from each applicant. However, denying a claim due to an honest mistake by the customer should be forbidden. So, how can you tell the difference between an honest mistake and a fraudulent application? First, a rescission can only occur when the claim is related to the error in the paperwork. If you forgot to mention a broken leg when you were a child and make a claim for a heart attack, the insurance company must honor the claim. Second, the rescission must occur within a reasonable amount of time -- I'd choose two years. Even if you have a family history of heart disease that you covered up, if you don't make a claim or if they don't catch you for two years, then you are free and clear. The third issue is intent and this is the hardest to determine. Did the applicant make an honest mistake or was he trying to cover something up? You have a heart attack after 6 months and the insurance company finds out that your estranged father was on medication for high blood pressure. That would be one for the courts or arbitration panel to decide.
An associated reform covers changes in premiums. Even if insurance is not rescinded, premiums could still rise after a customer has a serious illness. The term of an insurance contract and the allowable increases in premiums must be laid out in the initial contract. If you want a ten-year contract with premium increases restricted to 5% per year, then you could get it. A year-to-year contract would also be available with the knowledge that the customer is taking on the risk of premium increases.

The final major reform is the allowance of interstate competition and the removal of federal antitrust exemptions. Insurance companies are currently protected from federal antitrust laws under the 1945 McCarran-Ferguson Act. The supposed reasoning for this exemption is that they are regulated under separate state regulations with a prohibition against interstate competition. This results in individual state markets that are dominated by a single insurance company. Rates among states vary widely largely based on regulations that restrict risk-based premiums or require mandates that customers may not want. A twenty-five year old who doesn't want coverage for mental health care would be charged the same as a sixty-year old who wants his Viagra covered under a state mandate. Moves to repeal the antitrust exemption and to allow interstate competition are already underway and will hopefully pass regardless of the final health care reform.

          A brief overview of KinkyCare        
How should health care be reformed? Well, the Kinky Economist has a plan that provides for both universal health care and the best damn health care that money can buy. Anyone can get health insurance for free through the government. This public plan would be modeled on the VA system where the government owns the hospitals and the doctors and nurses are employees of the government, so members would not be able to choose their own doctor. Employment in the system could be worked into programs for medical school. For example, tuition is free at military academies such as West Point, but students are required to give four years of duty after graduation. The GI Bill will pay for college for soldiers after they leave the service. The federal government could pay for medical school with a requirement that the doctors work in the system after graduation.

The plan would focus on preventative care where annual check-ups are not only free, but you could get paid for a healthy lifestyle. So much of our health care costs, especially diabetes, heart disease, and respiratory problems, are driven by behaviors such as obesity, inactivity, and smoking. By focusing on wellness, these costs can be avoided (although healthier lifestyles do result in higher costs due to increased life expectancy and chronic diseases in old age).

Chronic and catastrophic health care would be rationed by Quality Adjusted Life Years (QALYs). For instance, the government may pay up to $40,000 for treatment that extends a patients life by one year, so the cost per QALY would be $40,000. Yes, health care will be rationed -- it is already rationed. Every scarce resource is rationed. If you don't want the plug pulled on Grandma. then pay for her health care. You shouldn't demand that other people to pick up the tab if you're not willing to pay the costs. If QALYs are used to ration health care, then how much are we willing to pay to save a life? More accurately, how much are we willing to make someone else pay to save a stranger's life? The budget for health care must be limited to a percentage of the total government budget. Once a fixed dollar value has been created, the cost per QALY will depend on how many people are in the government plan and how much health care they need. The government plan is meant for the poor and the sick, not the healthy and the wealthy. If more people get their own insurance, then the available funds can be spread among fewer participants resulting in higher costs per QALY. The plan can also accept contributions from donors that would increase the cost per QALY.

Another focus of the plan is positive externalities of health care. The plan could require patients to be immunized resulting in a reduced likelihood that other people will get sick. The plan could strongly encourage organ donation to help save other lives. The plan could be used for research on new medical techniques and drugs. All of these characteristics result in social benefits.

The final focus of the plan is cost containment. Treatments would be based on comparative effectiveness so that costly, ineffective treatments are avoided. Medical malpractice costs would be eliminated or at least drastically reduced by not allowing patients to sue or instituting a program to resolve these disputes. Generic drugs would be prescribed instead of brand names in order to lower pharmaceutical costs. Finally, the plan would use it's size to negotiate better terms for prescription drugs, medical equipment, and other purchases.

The public plan is not for everyone and most Americans can and should get their own insurance, just as they do today. However, the health care system does have flaws and room for improvements. The primary downfall of the plans that seem to be bandied about is the insistance on a single level of health care resulting in either reduced levels of care and/or higher costs. By recognizing that everyone deserves basic health care but not necessarily Cadillac care, I believe that the KinkyCare framework has the best potential to improve health care coverage and results.
          Express-Checkout Diabetes Care?        

I wonder, does your local shopping mall or drugstore contain a so-called Retail Clinic -- a mini-health clinic where nurse practitioners provide walk-in treatment for very basic health issues? I haven't experienced one in my neighborhood, but I a...

          WHY KOSAL STATE IS NECESSARY ?        

1-The creation of Orissa province has seen greatest sacrifice made by the Kosali people to accept coastal dialect as the official language even though Kosli-Sambalpuri remain as the sole language of their daily existence. Many Kosali people like Gangadhar Meher, Bhima Bhoi had contributed significantly towards Oriya literature.

2-The Kosali people had not only played a pivotal role in constructing the modern identity of Orissa state but also had made significant contribution towards the development and progress of the state.

3-The Kosali population, according to Census 2001, account for about 39 percent of the Orissa population and the Kosala make-up about 59 percent of the total area of the Orissa state. They contribute nearly 45 percent of total workers and 48 percent of total cultivators in Orissa. Kosala is the source of about 76 percent of net value-added generated in the Orissa manufacturing. In terms of forest resources, it contributes the highest percentage of forestland in Orissa with 66 percent of the total Orissa forest area. Further, Kosal is the richest source of minerals comprising iron ore, manganese ore, base metals (copper ore and lead ore), bauxite, china clay, coal, fire clay, graphite, limestone, dolomite, and precious minerals including diamond in Orissa. In fact the share of Kosal in the total reserve of minerals is 99 percent in the case of bauxite; 100 percent each in the case of coal, dolomite, lead & zinc, and limestone; 30 percent in iron ore; and 28 percent in the case of manganese ore. Its share in the value of mineral exploited in Orissa ranges from 100 percent in the case of Coal as well bauxite to 27 percent in the case of iron ore to 22 percent in the case of manganese ore during 2001-2002. In the case of Orissa’s own tax revenue, Kosal contribute about 39 percent of total sales tax and excise duties each, 33 percent of entertainment tax and motor vehicle tax each, 32 percent of general cess and nistar cess, and 30 percent of land revenue.

4-In the infamous backward districts of Kosal region of the KBK (Koraput, Bolangir and Kalahandi) about 68.8% persons live below the poverty line and even the Chief Minister of Orissa recognized the region to be the poorest region in India.

5-Apart from manifesting in starvation deaths the acute level of poverty in Kosal shows its ugly face in the form of child-selling. Although the news of child-selling dates back to 1985 when Phanas Punji, a thirty year old woman shocked the nation by selling her fourteen year old sister- in-law Banita Punji to one Vidya Podh for Rs 40 to buy food for her children in the Kosli district of Bolangir.

6-The apathy of Orissa government to the incidence of poverty in Kosal region has been most unfortunate in the last half a century. Whenever any news on starvation deaths appears in newspaper the first official reaction of the state government has been to simply deny such incident. The non-seriousness in the government response to the issue of poverty and starvation death in the Kosal had manifested in several cases of improper implementation of the projects sponsored by the central government meant for backward districts of Kosal as noted by the planning commission of India.

7-Various poverty alleviation programmes in Orissa have failed due to rampant corruption, unawareness of schemes amongst beneficiaries and wrong targeting of the beneficiaries. In many cases, the poor people of Kosal even cannot buy subsidized rice supplied through the public distribution system (PDS) due to lack of purchasing power.

8-The minimal developmental resources meant for Kosal region including poverty alleviation schemes has been systematically siphoned-off from the region to the coastal region through corruption.

9-The News Channel, NDTV, reported the acknowledgement of a government official about the system of paying commissions to a whole lot of people including senior officials and politicians even from the funds meant for Food for Work schemes
undertaken by the government of Orissa in the drought-affected districts of Kosal.

10-The large-scale misappropriation of Central aid coming under various social security schemes can be seen from the famous September 22, 1999 report of the then deputy administrator (Hrushikesh Panda) of the KBK (undivided districts of Kalahandi, Bolangir, Koraput) that had elaborated upon the widespread misappropriation of funds given by the Centre under agreement with the International Fund for Agriculture Development (IFAD) and the role of the then district collector, two directors of the IFAD project, and many other government officials forcing Central government to withhold the
aid to the poverty-ridden Kashipur block of Rayagada. The Hrushikesh Panda report noted that not a single plant claimed to have been planted under the programme can be traced, payments were made against non-existent works, roads were built from no where to no where, estimates of works were recklessly revised and only non-tribals were
handpicked as contractors by the officials.

The corruption money going into the account of bureaucrats straightly shifted to the Coastal region as majority of them belongs to that region.

11-This failure of the state government in checking corruption and properly addressing the grinding poverty in Kosal and the corrupted role played by government officials who invariably belong to the Coastal region has naturally fueled
discontentment among general Kosli people that they have not received their right share of development even though they are contributing major chunk of resources towards the state. The then Prime Minister of India, Shri Atal Bihari Vajpayee
summed up the developmental disparity in Orissa as follows:

“After touring western Orissa and interacting with the people of the region, I have come to the firm conclusion that the development of this part of the State, although rich in natural resources like mineral deposits and forests, has been neglected. This has resulted in the impoverishment of the people of this region, which has been left way behind by the developed areas of the State… The stark reality of poverty, hunger, starvation, illiteracy and malnutrition that one witnesses in vast tracts of western Orissa is further highlighted by the fact that the bulk of the people who have been denied  share of the development cake are tribals... In a sense, western Orissa is the real face of India. It is a matter of shame that fifty years after Independence people should die of hunger; that parents should be forced to sell their
children for a fistful of rice”.

12-The migrants from the Coastal region are in general economically better-off and educated and they migrate to other states mainly in search of better employment opportunities, and not so much because of desperate search of livelihood in the face of drought or famine, like people in Kosal.

13-Recently there has been a phenomenal increase in the number of women including pregnant one joining the flow of seasonal labour migration from the Kosal raising further issues of gender discrimination in wages, women facing increased health risks and threats of sexual exploitation. Several newspapers are reporting cases of sexual abuse of female workers and selling of child labour from Kosal in other parts of India.

The Coastal-dominated state government is completely insensitive to our issues and failed to address the real issues faced by us.

14-The poor performance of Kosal as compared to the Coastal region in the primary as well as higher stages of education may have resulted from various factors but the most important may have been the relatively low levels of government
educational expenditure devoted towards the region as compared to the Coastal region.

15-From the point of view of the access to university education through availabilityof educational institutions there has been a very strong sense of educational deprivation in Kosal. It has only one university, namely Sambalpur University,
situated at Burla, Sambalpur district catering to the educational needs of 14.3 million Kosali people spread across a geographical area of 98, 034 square kilometers. The Coastal region, on the other hand, host to a total of seven universities with per university catering of 3.2 million Coastal people spreading over a geographical area of
63,507 square kilometers. In terms of number of sanctioned seats at post graduate level (MA/MSc etc. and MPhil) there is glaring regional disparity in Orissa. The two major university of Coastal Orissa together have 2081 seat strength with a seat-population ratio of 93 seats per million population whereas the sole Kosali university, Sambalpur
University, has only 723 seat strength with a seat-population ratio of 51 seats per million population. Inclusion of other five universities to the list of Coastal region will further increase its seat-population ratio relative to that of Kosal.

16-One engineering college in Kosal covered about 24 lakh population whereas it covered merely 9 lakh population in the case of Coastal region.

17-Kosal goes without specialized research institutions as Central Rice Research Institute (Cuttack), Institute Of Physics (Bhubaneswar), Homoeopathic Research Institute (Puri), Regional Leprosy Training & Research Institute (Ganjam), Nabakrushna Chaudhury Development Studies (Bhubaneswar) etc. are located in Coastal region.

18-Kosal has seen relatively low level of quality of education even though it has the backlog of lowest literacy rate in Orissa as compared to Coastal region.

19-Kosal has largest percentage of single teacher schools at primary, primary & upper primary, and primary & upper primary & secondary/higher secondary levels of school education as compared to Coastal region.

20-In terms of the provision of school infrastructure over region mixed picture emerges. As far as the percentage of student enrolled in schools without building and without blackboard is concerned Kosal appears to be lagging behind Coastal but when considering student-class-room ratio (SRC) is concerned it is relatively better-off.

21-The Kosali people really do not understand why their own state people located in the Costal Orissa have opposed the proposal for making Sambalpur University a central university when this only institution is serving the whole of the Kosal region whereas the Coastal Orissa cornered a total of seven universities. The power politics at state
capital favour Utkal University to be made central university as a result of which the proposal to have a central university in Orissa has been lying in official document since long time. These un-helpful attitudes of the state government and Coastal people made Kosali people more aware that educational development of Kosal is not possible
under the present Orissa state.

22-Orissa government largely dominated by the Coastal leaders are ruthlessly insensitive to even the humanly issue like health and the natural solution for this discrimination is being sought in the formation of a new state.

23-It is most unfortunate that the people in Kosal region lacked the most basic health facilities which the people in Coastal region are getting, the Orissa government continues to expand relatively more public health services in Coastal region.

24-By 2002 the state government has added about 699 PHCs in the Coastal region compared with mere 467 PHCs in the Kosal region. Considering the population coverage per PHC and per doctor one may likely to conclude that this addition is justified as the Coastal region has got a higher figure than Kosal. However this conclusion is misleading as there are large-scale vacancies of sanctioned doctor posts in Kosal.

25-In the name of public health services the Kosal has got hospitals from the government without doctors and infrastructures.

26-One PHC in Kosal covered about an area of 165 square kilometers as compared to 81 square kilometers in the case of Coastal region.

27-The Kosali people got a real shock when the government of Orissa decided to set-up the All India Institute of Medical Sciences (AIIMS) in Bhubaneswar with utter disregards to the public opinion in Kosal. When there is already 4-5 super-specialty medical hospitals are already there in Bhubaneswar and another 2-3 in Cuttack hardly 25 kilometers away from Bhubaneswar and also numerous hospitals with modern facilities in the capital city there was no justification for setting up the AIIMS in Bhubaneswar.

Nowhere in the history of Modern Indian states, will one find such an example where a state deprived its 40 percent of population the spatial access to health services merely for the sake of keeping everything in one region.

28-Kosal have got relatively low level of spatial coverage by roads as compared to the Coastal region. Road networks cover 164 kilometer of area in the Coastal region whereas it is 138 kilometer in the Kosal region, the shortfall in the coverage is amounting to be 26

29-In Kosal only 34 post offices per 1000 square kilometers are available against 78 post offices in the case of Coastal region.

30-While the number of banking branches in the Kosal region is 5.6 per lakh population and 8.7 per 1000 square kilometer of area it is 6.1 per lakh population and 21.5 per 1000 square kilometer of area in the Coastal region.

31-The banking system has provided a per capita credit of Rs. 1255 to the developed parts of the Coastal region which is one and half times higher than the per capita credit given to the underdeveloped Kosal region (only Rs. 820). Malkangiri with Rs. 354, Nabarangapur with Rs. 398, Debagarh Rs. 421, and Sonepur with Rs. 419 represent the
four most lowly per capita credit receiving districts

32-On an average, every 8 out of ten villages in the Coastal region are electrified whereas this is the case of about every 6 villages in the Kosal region. The number of electrified villages was not even 5 out of ten villages such as Rayagada, Malkangiri, Koraput, Kandhamal, and Debagarh. Only 19 percent of Kosali household have access to electricity as compared to 27 percent of Coastal Household.

33-The Oriya Sahitya Samiti responsible for promoting Oriya language and literature has habitually favoured the Coastal dialect by various promotional schemes like providing cheap financing, publishing and instituting literary awards. The Samiti is bias against the Kosali/Sambalpuri language.

34-In the history of modern Orissa one will not find a single piece of evidence where the Coastal people have contributed anything to the cause of the Kosali/Sambalpuri language.

35-Contrary to the promotion, most of the video album- making companies like Samrat and Sarthak based in the Coastal region are loose large to bring out Sambalpuri video cds which are devastatingly filthy and distorted by copying Hindi songs and mixing them with Sambalpuri which undermines Sambalpuri as an independent language.

36-In the case of dance, while Orissa government is continuously promoting Odissi dance in Orissa as well as outside the state, the Kosali dance received the least focus of the government.

          Real inequality: why things are better than they seem and will almost surely get worse        
Inequality, when measured by consumption, is not nearly as pronounced. Flickr user Lee Jordan.

Technological advancement, John Nye argues, has benefited the poor, reducing welfare inequality, because the price difference between TVs, for example, no longer reflects such a disparity in functionality. Flickr user Lee Jordan.

Editor’s Note: Economic inequality, especially when it comes to income, has been a frequent topic on this page. It’s also been elevated to the level of national discourse as both political parties seek to carry the populist flag into this fall’s midterms.

But John Nye, of George Mason’s Mercatus Center, wants America to rethink the way it defines inequality, starting with how it’s measured. Many of the dollar measures used to express who’s better off than whom don’t accurately reflect geographical variance in purchasing power, for one, or across-the-board modernization of living standards, for another. Welfare inequality, he concludes, has declined.

But by failing to recognize that good news, Nye argues, America could be setting itself up for some much worse news. The more we try to chip away at income inequality, he explains, the more we’ll open the floodgates to other, more pernicious forms of inequality, like social or political connections, that aren’t so easily taxed away.

Simone Pathe, Making Sen$e Editor

Thanks to the bestselling book by French economist Thomas Piketty — “Capital in the Twenty-First Century” — income inequality remains a hot topic of discussion. (Did it ever go away?) Dozens of pundits, scholars and bloggers have already weighed in on this issue, either to support his policy proposals or to denounce his ideas. I want to muddy the waters a bit further by getting us to think more about what it is we’re trying to measure. In so doing, I bring both good news and bad news.

I make two claims: that in a very fundamental sense, real inequality has almost certainly declined over the last few decades, despite the problems brought on by the financial crisis, but that improvements due to stronger growth, productivity, and higher incomes will only alleviate some of our concerns while exacerbating the perceptions of inequality — perceptions that I predict will surely grow in the coming decades.

“Because the areas with the highest wages tend to have higher costs, our measures of both wealth and income exaggerate perceived inequality.”

First, the (somewhat) good news. Dollar measures of income inequality always exaggerate differences because what matters to people is what they can buy for their money and how much value they derive from what they have purchased. Are you really richer if you must spend $40,000 per year for a two-bedroom flat in Brooklyn, New York, than someone earning a bit less who spends $20,000 on a nice three-bedroom house in Brooklyn, Wisconsin?

In other words, our measures of inequality are imperfect and rely to a great extent on our ability to obtain good prices with which to compare nominal incomes over time. For example, if we simply take people’s dollar incomes (or wealth, the point is the same) we need to deflate this by the cost of living. But whose cost of living? If we measure income inequality using average prices for the U.S. as a whole, we will be exaggerating differences in inequality between high-cost and low-cost areas. Whether $50,000 a year is a good salary depends a lot on whether you live in the urban Northeast or rural Midwest. Because the areas with the highest wages tend to have higher costs, our measures of both wealth and income exaggerate perceived inequality.

Consumption inequality

But ultimately, income is not a question of how many zeroes are in your bank account, but how much you can buy in goods and services. People have tried to circumvent this by measuring not just income but consumption. The data on consumption, derived from the government’s Consumer Expenditure Surveys, shows that consumption inequality has not matched the rise in income inequality over the last two to three decades.

Moreover, even consumption, as measured by dollars spent, overstates inequality. Thus if I spent $400 a month on food and you spent $200 per month, my food consumption is double yours even if we bought exactly the same things at different prices. Measures of consumption expenditure ignore differences in the prices of what we consume. This is true even when statisticians leave out rural areas to make comparability easier. But even within urban areas, if those with lower incomes are concentrated in lower-cost areas relative to higher-income areas, then using an expenditure measure is likely to overstate the differences in actual consumption. If you buy the exact same sandwich or haircut as I do but at a higher price, in what sense is your consumption greater than mine?

Many researchers feel that consumption inequality is understated and that true measures of consumption expenditure show much greater inequality. But these adjustments focus on dollar expenditures that aren’t corrected for cost differences. They just assume if you spend more, you’ve consumed more. But to assess real inequality, we care about how different the mix of goods and services is that different people consume.

There is an even deeper problem that causes us to exaggerate differences in consumption between the rich and the poor: changes in the quality of goods are not properly accounted. The march of technology means the good becomes commonplace and the best is often only incrementally better, but usually costs a lot more money.

Doubling the price of an item doesn’t give you twice as much. As technology progresses, the price differences between low-end and high-end goods conceal relatively small differences in functionality. To take a simple example: If a good 25-inch cathode ray tube color TV cost $500 in 1990 and a larger flat screen TV cost about $2,000 in the same year, would you think that someone buying a TV today would get as much of a jump in quality for the equivalent price difference? For $500 today, you could get a flat screen TV not that much worse and only somewhat smaller than you could buy for $2,000. Some of the differences, such as 3-D capability, might not even matter to most consumers. Yet in both cases, statisticians treat the higher spending person as having consumed four times as much as the one buying the cheaper TV.

Or think of coffee. That one person spends less than a dollar a day on coffee and another spends $5 may reflect differences in quantity or the fact that one brews at home and the other goes to Starbucks. That’s not the kind of difference that would have been felt much earlier in the 20th century, when having regular coffee of any grade was itself a small luxury.

“Technology has turned many luxuries into commodities and made it much harder for the rich to distinguish what they consume from the cheaper but functionally similar products used by the average person.”

Likewise, sugar and salt were historically expensive goods, yet in our time, they cost so little that the average family does not rush to stock up if salt falls in price by 50 percent. Or think of watches: Fifty years ago, a $1,000 Swiss watch was functionally superior to one that you might have bought for $100. Today, a $10,000 Swiss watch might be no better and, if it has a spring-driven mechanism, would actually tell time worse than a $10 Quartz wristwatch.

A better way to see how ignoring the relatively small differences in quality and functionality between many, even most, cheap and expensive goods distorts inequality comparisons is to do a thought experiment. Take two families. Family A lives in a distant suburb on take-home pay of $30,000 a year in a small two-bedroom apartment. Family B lives on $150,000 a year in the big city in a similarly sized two-bedroom flat. Despite the similarity in flat sizes, we would agree that the first family will be much more constrained in its choices than the second one. Family B gets to buy mostly more and better goods than Family A.

Now pretend that a magical box is invented so that for pennies, either family can produce any material item they desire of any arbitrary quality. Want clothes? Punch in the design, and for a nickel, you have the latest fashions. Need a computer? That too will pop out cheaply. Ditto for food and drugs. We would all agree that no matter what their dollar incomes, the families with that technology would be more equal than Families A and B are today.

So imagine that in this futuristic scenario, the two families are essentially equal on most margins with this magical box, but Family B earns 10 times as much as Family A ($300,000 versus $30,000) and both have to spend most of their money on a two-bedroom flat. The statistics would show a net increase in inequality, even though most would agree that by any reasonable reckoning the two are in fact more equal now in terms of what they can consume and how similar their consumption patterns would be. Of course, this is fantasy, but the general trend in material progress is well captured by this hypothetical. Technology has turned many luxuries into commodities and made it much harder for the rich to distinguish what they consume from the cheaper but functionally similar products used by the average person.

It is in this sense that no matter the measured gap in inequality, real welfare inequality is much less than earlier in our history. That the poor and the rich are not living so differently is perhaps more readily seen in the convergence in mortality rates between the rich and the poor and the fact that the largest parts of the remaining differences are heavily driven by behavior (smoking, obesity, accidents) and from having intact families — and not by lack of access to basic health care. The fact that it is hard to do these comparisons does not change the fact that it is these differences in outcomes, given similar behavior and family, that should be the ideal measures of changing health inequality.

“It is in this sense that no matter the measured gap in inequality, real welfare inequality is much less than earlier in our history.”

Thus in the long run, technology tends to favor the poor. Contrary to common wisdom, current research suggests that the 19th century saw a decrease in inequality when measured in consumption terms. Before industrialization, the rich had silks, where the poor might not have had underwear at all. Cheap cotton and then wool and then synthetics made it possible for all to have more than ample clothing. Today, companies such as Uniqlo have gotten rich off their ability to mimic more expensive fashions at more modest prices. Though differences persist, they are smaller or more subtle than before. In fact, the rise in average wages hurt the rich in one very noticeable way: As the rich tended to consume labor in the form of household workers or personal services, the rise in incomes disproportionately increased the cost of goods that the rich tended to buy (otherwise known as the “servant problem.”)

So much for overstated inequality

But now here comes the bad news. There are important dimensions on which inequality persists and worse yet, will loom larger in the coming years, even if technological progress rebounds to increase prosperity for all. In fact, the more we are able to overcome the plagues of hunger and want, the more likely the inequalities that remain will sting and be sources of conflict.

It is not a surprise that when people worry about the cost of living, the item that looms large in comparisons is housing. But is housing just about housing? A four-bedroom McMansion that might cost $1 to $4 million to purchase in a highly desirable area might only cost $200,000 or $300,000 to build in a remote rural area. In that case, are we really complaining about inequality of housing or of where the house is located?

And this constitutes the nub of the problem. People live to be nearer to work and to people like themselves, to find safe neighborhoods, and to ensure quality schools for their children. But all of these things depend heavily on what other people are doing, not on absolute income per se. Moreover, other factors such as desirable views of the lake or mountains or proximity to the nicest clubs and theaters downtown are inherently limited, “positional” goods that are not easy to replicate even with the best technology. To oversimplify, if there is one area in the city that everyone agrees is the “best” location to live in, then by definition, no amount of economic growth will make it possible for all to live in that location. Economist Fred Hirsch made this argument back in 1978 with his book “The Social Limits to Growth.” Inequality, and therefore the social value of positional goods, has been growing ever since.

Similarly, technology may lift the educational value of almost all universities, but so long as there is a benefit to going to the top 20 universities, no matter how those are defined, then by construction, there will always only be 20 top schools — and that is independent of wealth or demand (though they can weakly accommodate this through growth, while in the process diluting their desirability as selective institutions).

These are called positional goods in the sense that their value depends greatly on their relative status. Some goods, such as housing, could be a combination of material aspects (construction, amenities) and positional goods (location). Others might be mostly positional, as is the case with top universities. Technology cannot do anything to produce such goods, or at any rate produce them in ways that would easily match overall growth.

While it is imaginable that highly desirable new cities will emerge in the future, their desirability in the overall pecking order will likely either constrain demand or else displace a “cooler” city in attracting the wealthiest inhabitants and most skilled workers. In fact, economic growth makes this problem even worse. To the extent that technology and growth alleviate those inequalities that are purely material (e.g. access to initially rare drugs or expensive new electronics), the remaining inequalities will by definition be those that are more intractable. For example, if powerful people’s capacity to obtain more goods and services than us comes not from their wealth but from their political influence, social position, fame, beauty or charm, then it becomes much harder for the rest of us to attain equality. Just think of clubs with “face control” or restaurants that seat customers at desirable tables on the basis of their fame or attractiveness. If you can’t pay for better service and must rely on the discretion or whims of the staff, then the inequalities that persist will most likely be insurmountable for most people. A world that eliminated disparities in wealth but still maintained vast disparities in power or influence would effectively replicate those aristocracies liberal nations sought to overturn.

Some writers — such the economist Robert Frank — have used the positional goods race to argue for higher taxation of consumption; the idea would be to discourage destructive positional competition, which he likens to an arms race. But all this will do is reduce competition in dollar terms. Competition will shift to other dimensions (such as the aforementioned political power, persuasive ability or physical attractiveness) that are even less fungible and often more inegalitarian than income.

“Our fixation on income inequality (which I am certain will not disappear under any feasible policies) will obscure the fact that trying to tax away or regulate those inequalities will give more play to inequalities that are even less tractable, like social or political connections.”

Communist nations such as the Soviet Union were not more equal than Western nations, they had simply suppressed income disparities. Moreover, the assumption that positional competition is inherently wasteful is unfounded. The need of many to one-up their neighbors has often led to productive innovation. Without early adopters who first fought to get Blackberries, and then iPhones, would the mobile market be as well developed? And status-seeking has allowed for socially valuable charitable giving on the part of plutocrats who might otherwise focus exclusively on enriching their descendants.

Our fixation on income inequality (which I am certain will not disappear under any feasible policies) will obscure the fact that trying to tax away or regulate those inequalities will give more play to inequalities that are even less tractable, like social or political connections.

Zoning restrictions and rent control, for example, have not made Manhattan’s housing affordable. If anything, rent control has led to the spectacle of wealthy or influential people occupying luxury accommodations at bargain basement prices. (In the 1980s, because of rent control, New York City Mayor Ed Koch was famously paying about $475 for an apartment worth $1,200 a month.) When transparent market pricing is not allowed to hold sway in a market with high demand, other forms of influence – as well as money – will play a much larger role in distributing desirable resources.

Consider just one example from France: the Socialist leader and former managing director of the International Monetary Fund Dominique Strauss-Kahn did not receive an unusually high salary but had benefits which included the right to fly first class on Air France at any time, including the right to arrive at the last minute and be guaranteed a seat even if the plane was full. No billionaire has those rights, which cannot simply be purchased.

Schooling is especially positional – and especially resistant to solutions like Frank’s consumption tax (although that policy might be good for other reasons). That’s because school is a mix of absolute learning and of access to good or elite students. Consider that the number of Ivy League schools won’t increase as population increases. So while the median state school is vastly better than it used to be and the gap in what you can study has shrunk between the average and the elite schools, the social benefits of going to the top few universities have grown to the point where admission committees wield extraordinary influence and can make arbitrary decisions as to which sets of characteristics give kids a leg up. Large donations help, but so does coming from a well-connected political family or being a Hollywood celebrity. If taxing wealth made it harder to buy one’s way into these schools (e.g. by restricting donations), it would substantially increase the arbitrary power of admissions committees, which would promote different types of inequality. It would make competition from the use of family connections, for example, even more significant.

Examples in Greg Clark’s recent book “The Son Also Rises” also show that efforts to tackle income inequality do little to eradicate other, more persistent inequalities like the social mobility gap. Despite progressive taxation, egalitarian Sweden seems to have about the same degree of long-term social mobility as the United States. And the presence of elite families in China’s top universities seems no different than elsewhere despite the Cultural Revolution and half a century of Communism.

Indeed, focusing on wealth inequality can obscure situations in which social inequality is being improved by allowing larger income inequality. Just consider a CEO of a protected industry that is not threatened by takeovers or foreign competition. That CEO can enjoy many untaxed perks, and therefore, will need a lower salary, all else equal, than someone in a more open, transparent market where the most desirable managers are still paid more than ordinary workers. Traditionally, their compensation partly came in the form of various perks, as well as social prestige and influence. But the fewer the perks, the fairer the rules, and the greater the competition for those slots, the higher the salaries one would have to pay to those who really are on top.

Indeed, to the extent that the U.S. and a few other countries have been moving to more transparent compensation, greater taxation of perks, less deference from subordinates, and greater rights of shareholders, we should expect that the measured compensation of CEOs and managers will only increase, holding all else constant.

It is likely, for example, that if countries such as Japan were to play by the more open competitive rules of the U.S. economy, with greater restrictions on perks, less acceptance of collusive arrangements, and were more subject to foreign competition and threats of takeovers at home, we would shortly see that leading firms would end up having to pay even more for the CEOs or managers that firms wanted to retain, aside from the vexed question of whether these managers “deserved” their high pay. Paying them more would certainly increase measured income inequality while possibly reducing true inequality both within and across firms. Even in the U.S., how many top managers would accept lower salaries if women and foreigners were not allowed to compete for their positions, office perks were untaxed, and hostile takeovers were illegal?

Humans care about goods and humans care about relative status and that means that no matter how much progress we make in providing for all, we will undoubtedly see even more vicious conflicts about positional inequality in the years ahead, even if they are couched in such terms as “good schools” or “affordable housing.”

The post Real inequality: why things are better than they seem and will almost surely get worse appeared first on PBS NewsHour.

          NHS In Free For All?        
Poor old NHS, a creaking giant born of good intentions, the saviour of many, the tormentor of some. Say what you will, a service where everyone payed in to provide health care for all seemed to be a good idea at the time. Or was it? According to critics both here and in America, the National Health Service of Great Britain is a disgrace. They say we are subjected to governmental control and tyranny in order to access basic health care for which, they say, we wait and wait for no good reason. And what's more we have awful teeth. Nice. How kind of them to mention it.

I've worked in the NHS all my adult life, and quite frankly despite all the negative press I'm proud of what can be achieved, although I'm the first to agree it isn't all good news. That much is obvious. Since 1969 I've seen many changes, many different incentives and initiatives relentlessly pursued only to be abdandoned and tried again years later with the same disappointing results. I've witnessed the rise and rise of superbugs, the lowering of cleaning standards, the out-sourcing of basic services which are often substandard, the ridiculous obsession with producing statistics rather than genuine improvements in patient care. Whole hospital departments exist merely to collect raw and sometimes inaccurate data, mould it into the required good news format to be used in the never ending game of ping-pong politics in which the NHS has become the continually battered ball. Point scoring results can be manipulated to order, depending on who's asking the question and what they want the answer to convey. Legions of career focused hospital managers now spend their time in meetings about finances, targets and cuts whereas at one time they used to know more about patients' needs, the local population, the value of their staff. Sadly, that's all in the past.

Yes, there's plenty to be negative about if we want to look and look and look for it, but whilst we're having such a close look I'd urge anyone who's at all interested in fair play and a balanced argument to take care not to ignore the tremendous good that is also achieved.

In the years I've worked in the health service, I've seen kids who would never have previously survived into adulthood given transplant surgery which has provided them and their families with a future. There are chronically ill people in the UK who are being kept alive by combinations of drugs/therapy/care, all free at point of delivery. What would happen to them if it wasn't for the NHS? Babies smaller than bags of sugar (much smaller, actually) are now routinely cared for in amazingly expensive high-tech units until they're big enough to go home, when the nursing staff joyfully hand the parents a baby, not a bill. Every day we can freely go to our GP's surgery, or take part in some sort of health screening, or be seen by a consultant without taking a credit card with us (although change for the carpark would be handy), but these treatments come at a cost and these costs come from our contributions, and we who contribute do so on behalf of everyone. I think we can be proud of that.

I'll not try to pretend that there isn't massive room for improvement in the NHS and admit that there are very, very many cash-strapped services which are not up to a good enough standard, and yes, our demands for health services outstrip the available supply because there simply isn't enough to do everything everyone wants, so yes, we sometimes have to wait. And sadly, yes, some people have been very badly let down by the NHS for many different reasons. But please don't forget the millions and millions of people who owe their health and wellbeing to it, who have been treated successfully and well and are living proof that when the National Health Service is allowed to work, it works. It may be a long way from perfect, but at least you can rest assured that the first question a patient is asked before treatment in a British A and E Department is never going to be "who will pay?"

For me, the sight of people in the US with no health insurance queueing up before dawn in order to see a doctor, certainly vindicates our NHS warts and all.

And yes, in this country you can get those treated for free too.
          (USA-ID-Idaho Falls) Home Health Aide - CNA - PRN        
Our Home Health Aides assist with various personal care issues including changing bedding, changing clothing, bathing patients, and helping with hygienic routines such as brushing teeth, washing hair and keeping wound dressings clean and dry. Our Home Health Aides may assist patients' family members in caring for their relatives by instructing them on how to go about performing basic health-care routines. Home Health Aides consult on a regular basis with their supervising registered nurses in terms of keeping team members apprised of our patients' progression and the families' needs. + Must possess a valid state driver’s license. + Must possess automobile liability insurance. + Must wear seat belts at all times while driving. + Dependable transportation kept in good working condition. + Must be able to drive an automobile in all types of weather conditions. + Currently certified in the State of Employment. Our employees think Encompass is a great place to work and it shows! We have been repeatedly honored on a national and regional basis as a “Best Place to Work”. Here are just a few of the many reasons why: + We have been in business since 1998 and have established a stable and strong financial base. Click here to see a list of the many locations where we do business. + We have achieved consistent, double-digit growth percentages year after year. + Our leaders, from the CEO to our local office Directors, have open door policies and care about our employees’ input, satisfaction, and professional growth. + We do not tolerate unethical behavior or questionable business practices. + We promote our existing employees to leadership positions whenever possible. A great place to work starts with great employees committed to a great mission! Join us…as we continue to provide “A Better Way to Care”. EOE External Company Name: Advanced Homecare Management, Inc. External Company URL:
          (USA-MI-Southfield) Home Health Aide Homecare        
ResCareTitle: Home Health Aide (Homecare)Job Category: Direct Care/OperationsLine of Business: HomeCare ServicesAbout ResCareJoin us in transforming peoples' lives and their communities! ResCare is a one-of-a-kind human services company offering services for people with intellectual and developmental disabilities, home care for seniors, as well as education, vocational training, and job placement for people of all ages and skill levels. Right now, we have an exciting opportunity for you to join our team as a Home Health Aide (Homecare). In this position, you will play a vital and positive role in helping our clients with intellectual, cognitive, or developmental disabilities achieve their fullest potential.Are you passionate about helping others? Don't miss this opportunity to find career success and fulfillment while you help people reach their highest level of independence! Apply today! ResCare. Where Care Meets Career.About This Career OpportunityWe have an exciting opportunity for you to join our team as a Home Health Aide (Homecare). In the position, you will play a vital role in helping our clients with intellectual, cognitive, or developmental disabilities achieve their highest level of independence. Not only will you see positive results of your work every day, but you will have an opportunity for professional development and advancement to positions of greater responsibility. Many leaders with ResCare began their careers as Direct Support Professionals.Home Health Aide (Homecare) Responsibilities•Responsible for assisting clients with either personal care or home management tasks.•This would include assistance with basic personal hygiene and grooming, feeding and ambulation, medical monitoring, and other basic health care related tasks.•Home Management includes tasks that include basic housekeeping, shopping and other related housekeeping tasks.Specific Requirements•Must be 18 years of age or older. Ability to communicate both verbal and written.•Capable of working responsibly with confidential information.•Must be able to work independently.Additional InformationBenefitsIn addition to meeting your passion for making a difference in people's lives and career advancement, opportunities youmay also be offered:•Competitive pay based on experience•Medical, Dental, VisionBenefits•Suite of voluntary insurance options•401(k)•Paid Time Off•Holidays•Performance incentives•Company Discount Purchasing Program•Cell phone Service•Ford and Chrysler Automobiles•Furniture•Appliances•Staples discounts•Employee Assistance Program•Legal Assistance Program•Tuition Reimbursement•Predictive Full-time, 40 Hour Plus Schedule•Part-time and On-call shifts available (less than 30 hours)Don't miss this opportunity to find career success and fulfillment while you assist people to reach their highest level of independence.ResCare does not discriminate against any person on the basis of gender, race, color, national origin, religion, disability, age, veteran status, or sexual orientation in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of gender in its health programs and activities.Email:homecarejobssouthfield@rescare.com29200 Southfield RoadSuite #101A Southfield, Southfield, MI 48076-1924 USAResCare is an Equal Opportunity Employer. ResCare does not discriminate against any person on the b
          (USA-UT-Ogden) Home Health Aide - CNA - PRN        
Our Home Health Aides assist with various personal care issues including changing bedding, changing clothing, bathing patients, and helping with hygienic routines such as brushing teeth, washing hair and keeping wound dressings clean and dry. Our Home Health Aides may assist patients' family members in caring for their relatives by instructing them on how to go about performing basic health-care routines. Home Health Aides consult on a regular basis with their supervising registered nurses in terms of keeping team members apprised of our patients' progression and the families' needs. + Must possess a valid state driver’s license. + Must possess automobile liability insurance. + Must wear seat belts at all times while driving. + Dependable transportation kept in good working condition. + Must be able to drive an automobile in all types of weather conditions. + Currently certified in the State of Employment. Our employees think Encompass is a great place to work and it shows! We have been repeatedly honored on a national and regional basis as a “Best Place to Work”. Here are just a few of the many reasons why: + We have been in business since 1998 and have established a stable and strong financial base. Click here to see a list of the many locations where we do business. + We have achieved consistent, double-digit growth percentages year after year. + Our leaders, from the CEO to our local office Directors, have open door policies and care about our employees’ input, satisfaction, and professional growth. + We do not tolerate unethical behavior or questionable business practices. + We promote our existing employees to leadership positions whenever possible. A great place to work starts with great employees committed to a great mission! Join us…as we continue to provide “A Better Way to Care”. EOE External Company Name: Advanced Homecare Management, Inc. External Company URL:
          (USA-CO-Denver) Home Health Aide - CNA - PRN        
Our Home Health Aides assist with various personal care issues including changing bedding, changing clothing, bathing patients, and helping with hygienic routines such as brushing teeth, washing hair and keeping wound dressings clean and dry. Our Home Health Aides may assist patients' family members in caring for their relatives by instructing them on how to go about performing basic health-care routines. Home Health Aides consult on a regular basis with their supervising registered nurses in terms of keeping team members apprised of our patients' progression and the families' needs. + Must possess a valid state driver’s license. + Must possess automobile liability insurance. + Must wear seat belts at all times while driving. + Dependable transportation kept in good working condition. + Must be able to drive an automobile in all types of weather conditions. + Currently certified in the State of Employment. Our employees think Encompass is a great place to work and it shows! We have been repeatedly honored on a national and regional basis as a “Best Place to Work”. Here are just a few of the many reasons why: + We have been in business since 1998 and have established a stable and strong financial base. Click here to see a list of the many locations where we do business. + We have achieved consistent, double-digit growth percentages year after year. + Our leaders, from the CEO to our local office Directors, have open door policies and care about our employees’ input, satisfaction, and professional growth. + We do not tolerate unethical behavior or questionable business practices. + We promote our existing employees to leadership positions whenever possible. A great place to work starts with great employees committed to a great mission! Join us…as we continue to provide “A Better Way to Care”. EOE External Company Name: Advanced Homecare Management, Inc. External Company URL:
          (USA-FL-West Melbourne) Home Health Aide        
Job Snapshot + Employee Type: Full-Time + Location: West Melbourne, FL + Job Type: Other + Experience: Not Specified + Date Posted: 8/8/2017 Job Description ResCare Title:Home Health Aide Job Category:Direct Care/Operations Line of Business:HomeCare Services About ResCare Join us in transforming peoples' lives and their communities!ResCare is a one-of-a-kind human services company offering services for people with intellectual and developmental disabilities, home care for seniors, as well as education, vocational training, and job placement for people of all ages and skill levels. Right now, we have an exciting opportunity for you to join our team as a Home Health Aide. In this position, you will play a vital and positive role in helping our clients with intellectual, cognitive, or developmental disabilities achieve their fullest potential. Are you passionate about helping others? Don’t miss this opportunity to find career success and fulfillment while you help people reach their highest level of independence! Apply today! ResCare. Where Care Meets Career. About This Career OpportunityWe have an exciting opportunity for you to join our team as a Home Health Aide. In the position, you will play a vital role in helping our clients with intellectual, cognitive, or developmental disabilities achieve their highest level of independence. Not only will you see positive results of your work every day, but you will have an opportunity for professional development and advancement to positions of greater responsibility. Many leaders with ResCare began their careers as Direct Support Professionals. Home Health Aide Responsibilities + Responsible for assisting clients with either personal care or home management tasks. + This would include assistance with basic personal hygiene and grooming, feeding and ambulation, medical monitoring, and other basic health care related tasks. + Home Management includes tasks that include basic housekeeping, shopping and other related housekeeping tasks. Specific Requirements + Must be 18 years of age or older. Ability to communicate both verbal and written. + Capable of working responsibly with confidential information. + Must be able to work independently. Additional Information Benefits In addition to meeting your passion for making a difference in people's lives and career advancement, opportunities you may also be offered: + Competitive pay based on experience + Medical, Dental, Vision Benefits + Suite of voluntary insurance options + 401(k) + Paid Time Off + Holidays + Performance incentives + Company Discount Purchasing Program + Cell phone Service + Ford and Chrysler Automobiles + Furniture + Appliances + Staples discounts + Employee Assistance Program + Legal Assistance Program + Tuition Reimbursement + Predictive Full-time, 40 Hour Plus Schedule + Part-time and On-call shifts available (less than 30 hours) Don't miss this opportunity to find career success and fulfillment while you assist people to reach their highest level of independence. ResCare does not discriminate against any person on the basis of gender, race, color, national origin, religion, disability, age, veteran status, or sexual orientation in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of gender in its health programs and activities. 635 South Wickham Road Suite 204 , West Melbourne, FL 32904-1436 USA ApplyApplyNot ready to Apply? CHECK OUT OUR SIMILAR JOBS
          (USA-NJ-BRICK) Certified Home Home Health Aide        
Assist clients with bathing, grooming. Basic health related services such as checking vital signs, administering medication.Light housekeeping chores-laundry, dishes, vacuuming in clients home. Organize client's schedule and plan appointments. Certified or trained to be certified. Must have a High School Diploma or GED, CHHA License a plus, Background check, Full time and Part time positions available. All shifts available, Sunday - Saturday. Positions available in Gloucester, Cape May, Burlington, Monmouth, Ocean, Camden, Salem, Somerset, and Middlesex counties.
          Nurses Join Movement to End Illinois Budget Crisis By Taking to the Streets        

This Memorial Day weekend, Illinois members of National Nurses United (NNU), including RN Martese Chism, will lace up their walking shoes and prove that “going the extra mile” to stand up for their patients is a promise they take literally.

Chism will be joining the entire final May 26–30 stretch of the “March to Springfield,” a protest led by Fair Economy Illinois, numerous groups and organizations so fed up with a nearly two-year delay on Democratic state assembly members and Republican governor Bruce Rauner passing a budget — that they decided to stand up and move on the budget themselves.

“My great-grandmother marched from Selma, Alabama to Montgomery, Alabama with Dr. Martin Luther King Jr. and Congressman John Lewis,” said Chism. “Ten months later, she was murdered by the Klan for registering blacks to vote. I was five years old. This weekend, I am going to march to Springfield, Illinois to pay homage to my great-grandmother and her activism by fighting for a budget that provides good jobs, support for our communities and protection for the environment.”

Chism speaks at the May 15 Chicago kickoff rally for the March to Springfield.

A 200-mile journey to Illinois’ capital, launched in Chicago on May 15, the March to Springfield is meant to draw attention to the impact of the budget crisis on everyday people’s lives. Marchers, who are stopping in cities along the way for “listening sessions” with local residents, are championing a “People and Planet First Budget” that invests in single payer/Medicare for all healthcare, good jobs, world class public education, free public higher education, safe infrastructure, and green energy. Funding, say the marchers, can come from closing corporate tax loopholes, raising taxes on higher income earners, and enacting a financial transaction tax (“LaSalle Tax”) on Chicago’s commodities exchange.

Too many people are suffering in the state of Illinois. Poverty, and the lack of opportunities have taken their toll,” said Chism. “Last year, more than several hundred people died from gun violence. Two of those lost were my [family members]. That’s why I march.”

“I worked for 8 years in the dialysis unit at [John H. Stroger Hospital of Cook County],” Chism continued. “Many dialysis patients end up in kidney failure because they don’t have access to the basic healthcare they need; that’s why I’m marching, to create universal, single payer healthcare in Illinois. I want to come together with everyone across the state to win a people and planet first budget. “

“This is not a political game. This is a crisis,” agreed Chicago-area RN JoAnn Lingle, who did around 10 miles of the March to Springfield earlier in the month, inspired by the need for single payer healthcare. “Lives are at stake.”

RNs Lingle (L) and Chism with a photo of Chism’s great-grandmother, a civil rights activist killed by the Klan for registering blacks to vote. Chism carries on a family tradition of activism and marches in honor of her great-grandmother.

Standing up for public health is a vow on which they will always take action, say nurses, everywhere they go.

“We’re going to keep fighting for what we need, what will make our communities more healthy,” said Lingle. “I believe change has to be from the grassroots up, nothing happens from top down. So we will keep on marching.”

Marchers will arrive in Springfield, May 30 at 10:30 a.m., to march the last half mile from the old state capital building to the capital, where hundreds will rally, lobby and hold a People’s General Assembly to do what the General Assembly hasn’t done in two years: pass a People and Planet First Budget. For more information about the march and how to get involved, visit

          Understanding and Promoting Health Literacy (HHS)        

Research grant applications on health literacy

Deadline: October 13, 2006

The goal of this Program Announcement is to increase scientific understanding of the nature of health literacy and its relationship to healthy behaviors, illness prevention and treatment, chronic disease management, health disparities, risk assessment of environmental factors, and health outcomes including mental and oral health. Increased scientific knowledge of interventions that can strengthen health literacy and improve the positive health impacts of communications between healthcare and public health professionals (including dentists, healthcare delivery organizations, and public health entities), and consumer or patient audiences that vary in health literacy, is needed. Such knowledge will help enable healthcare and public health systems serve individuals and populations more effectively, and employ strategies that reduce health disparities in the population. Healthy People 2010 defines health literacy as the "degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions" (U.S. Department of Health and Human Services, 2000). Many factors affect individuals' ability to comprehend, and in turn use or act on, health information and communication. Proficiency in reading, writing, listening, interpreting, oral communication, and visual analysis is necessary as the modern health system typically relies on a variety of interpersonal, textual, and electronic media to present health information. Individuals and families both must be able to: communicate with health professionals; understand the health information in mass communication; understand how to use health-related print, audiovisual, graphical and electronic materials; understand basic health concepts (e.g., many health problems can be prevented or minimized) and vocabulary
(e.g., about the body, diseases, medical treatments, etc.); and connect this health-related knowledge to health decision-making and action-taking. Access to and understanding of health information and services is a reciprocal process among health professionals, communication professionals and patients. For instance, these professionals must use science-based strategies and tactics, develop resources and materials, and understand communication interactions between providers and patients. Research on health literacy should assist NIH in its mission of communicating scientifically-based health information to the public and to the health care providers and related professionals who serve the public.

          Critical illness rider: A must for Indians        

Avail a crucial additional cover for a nominal additional premium.

The recent Global Burden of Disease (GBD) studies show that cardiovascular diseases are the leading cause of deaths in India. These diseases include ischemic heart disease, Chronic Obstructive Pulmonary Disease (COPD) and stroke.

Treatment for all of these critical illnesses is very expensive. While basic health insurance policies do cover these illnesses, thesum assured they offer is highly inadequate. For example, most health insurance policies offer a sum assured of 2 to 5 lakhs (family floater), while the treatment for ischemic stroke itself amounts to 6 lakhs. Here, traditional life insurance policies are also of little help because they grant the sum assured upon the demise of the insured.

This is where the critical illness rider is useful.

What is a Critical Illness Rider?

A critical illness rider is an optional add-on feature that can be bought to compliment the life insurance policy. It ensures that a lump sum (Sum Assured) is paid to the policyholder if he or she is diagnosed with any of the critical illnesses specified -inthe policy. Once the payout is made, the rider terminates while the life cover under the Base Plan and other riders (if any) continue.

What are the illnesses covered under the Critical Illness Rider?

Each insurance company covers a different array of illnesses under this rider. However, the critical illness rider typically covers:

  • Cancer
  • Open Chest CABG
  • First Heart Attack
  • Stroke

Some companies also offer special Women Critical Illness riders.

What are the conditions of the Critical Illness Rider?

Although the critical illness rider covers the specified illnesses completely, there are a few scenarios where claims are rejected. Generally:

  • The rider does not cover pre-existing or hereditary conditions
  • Claims can be made only if the illness is diagnosed after the waiting period
  • Claim is paid only if the insured survives a specified time frame after diagnosis of illness

What are the types of critical illness riders available?

  • Core/ Non-Accelerated Critical Illness Benefit
    Here, the sum assured under the critical illness cover is independent of the death benefit. The benefit paid by the rider does not affect the death benefit of the life insurance policy.
  • Accelerated Critical Illness Benefit
    Under this kind of critical illness rider, the benefits paid can reduce the death benefit of the base policy.

Also see: Add an extra feature to your policy by opting for a ‘Rider’

          Penetration of Smartphones and Smart Devices to Boost mHealth Services Market        
mHealth or Mobile health has of late seen increased activities from across industry verticals. Due to rapid penetration of smart devices and smart phones, it is now becoming conceivable for mHealth service stakeholders to deliver basic healthcare services to prospective end users. The low cost and thus increased affordability of smartphones is driving the market. As per mobility report by Ericsson Mobile Platforms AB, smartphone subscriptions is expected to triple and also the smartphone traffic is expected to increase 10 times the current traffic, in the period form 2013 and 2019. In the same fashion, the advancement of high speed networks is expected to boost the demand for m-health services. Growing Prevalence of Chronic Diseases to Drive mHealth Services Market The growing number of patients suffering from chronic diseases is one of the key factors boosting the demand for mHealth services. Chronic diseases require continuous monitoring and long term medication, which can be done by making use of mHealth technology, services, and solutions. mHealth services act as a solution for the independent nature of the aged population, and are thus becoming increasingly popular. The growing geriatric population is also an important factor leading to a significant adoption of these services across the globe. Moreover, the growth in number of application areas of mHealth in the recent past has helped the mHealth services market to grow. mHealth or Mobile health has of late seen increased activities from across industry verticals. Due to rapid penetration of smart devices and smart phones, it is now becoming conceivable for mHealth service stakeholders to deliver basic healthcare services to prospective end users. The low cost and thus increased affordability of smartphones is driving the market. As per mobility report by Ericsson Mobile Platforms AB, smartphone subscriptions is expected to triple and also the smartphone traffic is expected to increase 10 times the current traffic, in the period form 2013 and 2019. In the same fashion, the advancement of high speed networks is expected to boost the demand for m-health services. Growing Prevalence of Chronic Diseases to Drive mHealth Services Market: The growing number of patients suffering from chronic diseases is one of the key factors boosting the demand for mHealth services. Chronic diseases require continuous monitoring and long term medication, which can be done by making use of mHealth technology, services, and solutions. mHealth services act as a solution for the independent nature of the aged population, and are thus becoming increasingly popular. The growing geriatric population is also an important factor leading to a significant adoption of these services across the globe. Moreover, the growth in number of application areas of mHealth in the recent past has helped the mHealth services market to grow. Stringent Regulatory Norms to Challenge Growth of Market The food and drug administration (FDA) authority in the United States has implemented stringent regulatory norms so as to measure outcome and effectiveness of mHealth solutions and services. This is acting as a restraint for the mHealth solutions and services market. These regulations are continuously amending and is expected to challenge the growth of the market. The food and drug administration (FDA) authority in the United States has implemented stringent regulatory norms so as to measure outcome and effectiveness of mHealth solutions and services. This is acting as a restraint for the mHealth solutions and services market. These regulations are continuously amending and is expected to challenge the growth of the market.

Original Post Penetration of Smartphones and Smart Devices to Boost mHealth Services Market source Twease
          Myanmar cyclone two years on: Aid effort only a quarter funded as survivors face another monsoon season        

International aid agency Oxfam called for additional funding for the 2008 Cyclone Nargis survivors in Myanmar today, saying the upcoming monsoon season is posing a serious threat to their recovery with shelter still a pressing need and agriculture at risk.

“Two years into the current three-year international appeal for Myanmar’s recovery, only about a quarter of the money needed has been pledged. The aid successes of helping rebuilding lives are at risk if people cannot secure their homes. Money is also needed for providing drinkable water and improving sanitation and livelihood. The international community was generous when Myanmar’s crisis was on our TV screens, it should not look away now,” Oxfam’s spokesperson for Myanmar Country Program Grace Ommer said.

According to Tripartite Core Group, a mechanism comprising the Myanmar government, the Association of South East Nations (ASEAN), and the United Nations established to oversee relief and recovery efforts, only about $180 million has been received out of estimated $691 million needed between 2009 and 2011 to restore people's lives back to what they were before the cyclone.

Main picture: 
Fisherfolk have reported a significant decline in fish catches in the years following Cyclone Narigs. Oxfam has provided farming and fishing equipment to 11,500 families. Credit: Aye Zaw Myo/Oxfam
Pull quotes: 
The aid successes of helping rebuilding lives are at risk if people cannot secure their homes.
Quotee's organisation: 
Oxfam’s spokesperson for Myanmar Country Program
Notes to editors: 

Approximately 140,000 people were killed or went missing when Cyclone Nargis hit the southern part of Myanmar on May 2, 2008. The cyclone, which was the worst natural disaster in Myanmar and the 8th deadliest in the world, affected 2.4 million people in the Ayeyarwady Delta and Yangon and cost $4.1 billion in losses and damage.

  • According to the TCG, aid money to two crucial sectors for people’s recovery, shelter and agriculture, fell short by 60 per cent of the $158 million needed for last year’s recovery work alone.
  • In the Post-Nargis periodic Review II, it was found that apart from lack of assets and capital, which leads to lack to affordable credit access, critical needs remain in house repair, shelter, education, and water sanitation. Ninety-three percent of the households surveyed also could not afford their house repairs as they were severely or completed destroyed, with 74 per cent of the households citing adequate shelter as one of their most pressing needs.
  • An Oxfam assessment conducted this year also confirmed that one of the greatest obstacles faced by survivors is their inability to access credit. Many people whose credit-worthiness within their communities is low are excluded from this cycle. Therefore, initiatives by aid agencies to facilitate greater access to credit and networks have eased their burden significantly.
  • Statistics by the Organization for Economic Co-operation and Development showed that Myanmar received around $11 per person in 2008, while Cambodia, also an extremely poor country, received almost $52 per person.

What we have done: 

Oxfam is now working through partner organizations in Dedaye and Pyapon townships, and supports recovery efforts in eight cyclone-affected affected townships. We have assisted 500,000 people so far and spent approximately $14.8 million with partners on relief and recovery efforts over the last two years.

  • Ensuring access to safe water for 64,620 households through drilling of tube wells up to 560 feet which guarantee water’s cleanliness, the distribution of ceramic filters, water jars and containers so that people can collect, treat and store water safely,
  • Rebuilding  community ponds - this includes improved fencing to keep out animals, timber bridges, sand filters to remove impurities, and improvements to water collection points. This is still an ongoing work as the current basic healthcare services in the Delta are not yet well equipped
  • Giving materials to over 53,000 households to rebuild their homes and protect their families from the weather. The need for shelter remains an issue with approximately 160,000 households across the Delta requiring assistance
  • Supporting the rebuilding of schools, childhood care and development centers and providing school supplies, uniforms, and books, benefiting almost 19,000 students
  • Working with partners to build communal latrines and hand washing facilities. Oxfam is also promoting safe hygiene practices by carrying out demonstrations on safe water, latrine cleaning, safe food preparation, hand washing and soap distribution
  • Providing training, tractors, fuel, seeds, fruit trees, fertilizer, pigs, farming tools, boats, fishing nets and equipment to 11,500 households so they can continue farming and fishing. Together with its partners, Oxfam has provided training on organic farming techniques, compost making, establishing nurseries, pig raising, crab and eel fattening, animal husbandry techniques, and disease control
  • Providing emergency food or establishing cash grants and cash-for-work opportunities for over 26,400 households to help them recover and diversify small business opportunities
  • Conduct training to strengthen the ability of local organizations to manage finances, build confidence, and increase participation, particularly of women. Working with communities to strengthen their ability to prepare for and protect themselves against future disasters
  • Jetty construction in Chaungwa village on Pyinkhayine Island. This jetty is a lifeline for almost 18.000 population of the island.
Contact information: 
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Summary picture: 
Villagers carrying water collected from a pond in new containers. Oxfam has distributed ceramic filters, water jars, water storage containers and hygiene kits to 64,620 families. Credit: Aye Zaw Myo/Oxfam
Grace Ommer

          Spring schedule announced: Workshops coming to Durango, Glenwood Springs and more        
We have just announced several workshops, including Level 1s in metro Denver and Glenwood Springs, and advanced courses in Durango. These courses are FREE to patient navigators in Colorado!   Level 1 Workshops Patient Navigator Fundamentals is our three-day training for patient navigators who want to gain navigation skills and knowledge of patient resources, basic health […]
          The Exploitation of Maternal Mortality        

Fiorella Nash FAITH Magazine July – August 2011

Fiorella Nash argues that, faced with the terrible suffering of some mothers, the pro-abortion lobby can prefer to spin rather than help, and that pro-life people need to try to reverse the emphasis. She highlights a campaign trying to do that. An award-winning novelist, her latest acclaimed book, Poor Banished Children, is published by Ignatius Press.

I have admitted to friends on more than one occasion that when an obstetrician strode into the delivery room where I had been in the throes of an obstructed labour all day, I felt as though I were being rescued from a torture chamber. This is not what my most acerbic critic would call my 'fondness for hyperbole'. If anything, it is a ludicrous understatement. The obstetrician in question did not rescue me from a torture chamber, he rescued me - and my baby - from death sentences. Without the emergency intervention that followed, the baby would have suffocated in the birth canal in which he was trapped and I would have bled to death, which would at least have killed me within hours rather than over several excruciatingly painful days in the case of the obstructed labour.

I am acutely aware that I owe my life, and the lives of two out of three of my children, to the intervention of highly skilled doctors, midwives and paediatricians, and the proximity of well-equipped operating theatres and intensive care units. But I am also aware that every year, hundreds of thousands of women and babies experience no such reprieve from the preventable death sentence imposed when labour goes wrong and there is not even the most basic health care available to ease their suffering and save their lives.

In Britain the maternal mortality rate is 8.3 per 100,000 births (and this is by no means the lowest rate in the developed world). In Malawi it is 1140.1 per 100,000. Global spans are difficult to gauge because of poor reporting in some countries and differences in methods of reporting; for example, some countries will classify maternal mortality as the death of a woman within 21 days of birth, others 42 days; some include only direct causes - sepsis, haemorrhage, obstruction - whereas others will include indirect causes such as malaria and anaemia. Estimates therefore vary between 350,000 and 600,000 deaths a year but whatever span aid agencies quote, statistics alone cannot convey the full horror of young women dying unattended, in terrible fear and agony, leaving behind devastatedfamilies and other children whose own survival may well be jeopardised by the loss of a mother.

The greatest tragedy of all, however, is that these deaths are almost entirely preventable.

The Exploitation of Suffering Women

Maternal mortality has been rightly described as 'an international disgrace' but almost as grave a disgrace is the determination by pro-abortion groups to hijack the issue in order to promote abortion around the world. The abortion lobby has a long history of exploiting the suffering of women while claiming to act in their best interests. This is evident when it comes to the subject of abortion and rape, for example. Abortion is touted as the compassionate response to rape as though being physically invaded by a masked, anonymous male (usually), or given pills that cause bleeding and severe pain are cures for a brutal and traumatic act that will haunt a woman all her life. Every abortion practitioner knows that the overwhelming majority of abortions are carried out on social grounds andthe abortion lobby is unapologetic about its belief that abortion should be available 'on demand and without apology', yet it uses rape survivors as an emotive smokescreen to cover its unsavoury agendas and exploits their suffering for political and ideological gain.

The same is increasingly true of maternal mortality. Abortion continues to be touted as a women's health issue, from pro-abortion marches entitled "March for Women's Lives" to the emotive slogan shouted in the direction of many a pro-life demonstration: "Right to life, that's a lie! You don't care if women die!" Marie Stopes International's latest propaganda effort in the field of abortion and contraception promotion comes under the seemingly compassionate label of "Make Women Matter." But abortion has nothing to do with saving women's lives. As far back as 1992, a group of Ireland's top obstetricians and gynaecologists signed a letter in which they wrote:

"We affirm that there are no medical circumstances justifying direct abortion, that is, no circumstances in which the life of a mother may only be saved by directly terminating the life of her unborn child."

Where there sometimes is confusion (and I would venture that the abortion lobby is quite happy to encourage this confusion) is in rare cases where an obstetrician may be forced to intervene to save a pregnant woman's life, at the risk of losing the child. This is true of cases such as ectopic pregnancy, where the embryo becomes stuck in the fallopian tube and part of the tube has to be removed (usually along with the embryo) to prevent the woman from dying or in the case of pre-eclampsia at the other end of pregnancy. However, pre-eclampsia generally occurs after the baby is capable of being born alive and though premature delivery is almost always riskier for a baby than being carried to term, the odds are very much in favour of a baby's survival. Neither of these cases involves thedeliberate ending of a baby's life and cannot be labelled abortion. To do so is to fail to understand the principle of double effect.

Tellingly, countries such as Ireland and Malta where abortion is banned have some of the lowest maternal mortality rates in the world.

Women do, however, die as a result of abortion and it is the "unsafe abortion" argument that is being used most aggressively to promote abortion around the world. Our own Department for International Development uses unsafe abortion as its major line of defence in promoting and funding abortion, claiming that unsafe abortion is a major cause of maternal death. International organisations including the World Health Organisation list 'unsafe abortion' as a significant cause of maternal death after haemorrhage and sepsis but the category is misleading for a number of reasons.

First, this category usually includes deaths as a result of spontaneous abortion, otherwise known as miscarriage, giving a distorted picture of the number of women who are dying as a result of induced abortion. Second, it should be noted that it can be extremely difficult even for a trained doctor to determine whether a woman in the first trimester of pregnancy is experiencing life-threatening complications as a result of miscarriage or abortion. The symptoms are so similar that an online abortion group which sells pills to women in pro-life countries instructs women who suffer complications: "If you live in a place where abortion is a crime and you don't have a doctor you trust, you can still access medical care. You do not have to tell the medical staff that you tried to inducean abortion; you can tell them that you had a spontaneous miscarriage...The symptoms are exactly the same and the doctor will not be able to see or test for any evidence of an abortion."

Third, we should note the loaded use of "unsafe" here. Any medical procedure which involves the ending of one or both human lives involved is by definition unsafe and it is unsafe whether it occurs in Nairobi or New York. The abortion lobby has been very successful in creating a false association between 'safe' and 'legal' abortion (a favourite line of pro-abortion politicians is that abortion should be 'safe, legal and rare') with the implication being that if abortion were only decriminalised in every country of the world, maternal deaths as a result of abortion would be virtually eliminated. But any medical procedure involves a level of risk and abortion is no different, legal or otherwise. In developed countries (where abortion is most likely to be legal) 8.2\% of maternal deaths arethe result of abortion complications; in India, where abortion is legal, mortality from abortion accounts for around 16\% of all maternal deaths. South Africa, which has had abortion on demand for years has witnessed a fourfold increase in maternal mortality since a UK-funded abortion organisation set up clinics around that country. As SPUC's Peter Smith commented:

"It is farcical for the government to talk about safe abortions in situations without sterile surgical facilities, safe blood transfusion or emergency back-up. Running abortion clinics in slums, shanty towns and the bush will harm or kill women as well as killing babies." Women in Britain and women in South Africa have access to legal abortion, but in the end, a woman experiencing abortion complications in Britain can get emergency help within minutes; a woman living in an isolated settlement in South Africa can't. If the abortion lobby is going to highlight the risks to women of unsafe abortion, the logical response would surely be to campaign against a medically unnecessary procedure and to work instead to offer women the assistance they need when facing a difficult pregnancy?"

The desperate "they will do it anyway" argument is illogical and insulting to women. Some 10\% of 15- and 16-year-olds self-harm, the global mortality rate from suicide works out as approximately one death every forty seconds and the rate is rising, but it would be heartless and inhumane to suggest that vulnerable people should be taught how to cut themselves safely or to commit suicide in a way that inconveniences others as little as possible. The key question is, is it good?

A Pro-Life Response

It is not enough simply to condemn the actions of anti-life forces for exploiting the suffering of women to promote the ideology of abortion. The tragedy of maternal mortality needs to be addressed, not exploited, and it requires a courageous and honest response. It is for this reason that SPUC has launched The Mayisha Campaign (Mayisha meaning Life in Swahili) to raise awareness about maternal mortality, dispel the myths put about by abortion groups and lobby the Department for International Development to adopt an ethical foreign policy which respects the lives of both mothers and their babies. Abortion is not the sad necessity or the empowering procedure it is presented as by groups like Marie Stopes International and International Planned Parenthood Federation. It needs to berecognised as part of the problem. Dr Robert Walley, the British-born founder and director of the international organisation of Catholic obstetricians and gynaecologists MaterCare International, puts it succinctly when he says:

"Unfortunately, the international safe motherhood initiative has accepted the current culture of death prevalent in obstetrics and gynaecology, as abortion is included as the solution to maternal health problems. All of this points to a real poverty - the lack of love and compassion."

The staff and volunteers at MaterCare International (MCI) know something about love and compassion for the forgotten mothers of the developing world. They provide life-saving assistance to mothers in Kenya and Ghana and have been providing emergency help in Haiti since an earthquake devastated that country in January last year. They are forced to work without state funding and are entirely reliant upon donations from members of the public. MCl's mission statement links their work directly with Evangelium Vitae by "improving the lives and health of mothers and babies both born and unborn, through new initiatives of service, training, research, and advocacy designed to reduce the tragic levels of abortion worldwide and maternal and perinatal mortality, morbidity in developingcountries."

It was Dr Walley, who has witnessed first-hand the horror of young mothers dying for want of appropriate medical facilities, who suggested that to the Seven Sorrows of Mary an eighth sorrow should be added: the suffering of thousands of women who die giving birth to their babies and the millions who, in despair, turn to abortion.

As Catholics, we know instinctively that maternal mortality is a tragedy and that abortion is not the answer, but I believe that we are under an obligation to turn that knowledge into action and offer hope to mothers around the world who face the prospect of giving birth in fear and trembling rather than with joy. Whenever anyone tells me that a situation in a foreign country is none of their business, I ask how they would feel if their own sister were facing death for want of medical care that they themselves take for granted. This is not just an attempt to make people feel guilty. Feminists talk about the universal sisterhood while being prepared to show a remarkably callous attitude to women who fail to meet the entry requirements. Catholics must speak of sisterhood and show the worldwe mean it.

For more information about the work of the Mayisha Campaign or MaterCare International, check out:

          Historic 6th Annual Pharmaceutical Leadership Summit and Pharmaleaders Awards 2013 Focused to Give Aam Admi of India Affordable Medicines and Quality Healthcare        
Mumbai, Maharashtra, India:In a sequel to the sixty days of the voting by the Indian masses to select the best of the best in the final five nominees in various important categories & individual nonvoting categories, Pharmaleaders ( felicitated top performers in the healthcare industry & medical professionals in Mumbai on Friday,27th December 2013 at the historic 6th Annual Pharmaceutical Leadership Summit & Pharmaleaders Business Leadership Awards 2013 ( at the hand of Mayank Gandhi, Member, National Executive of the Aam Admi Party. Organised by Pharmaleaders, Asia’s leading healthcare media in healthcare communications & a division of Network 7 Media Group, The platform witnessed more than 300 professionals of the healthcare industry.

Satya Brahma, Chairman & Editor-In-Chief of Pharmaleaders in the opening address lambasted the union government for the faulty healthcare reforms & policy paralysis. In a scathing attack to the UPA regime, NPPA, Health Ministry, Ministry of Chemicals & Fertilizers, Satya highlighted the series of issues neglected by the authorities & blamed the central government for not listening to the long-standing demands of the sensitive healthcare industry in DPCO logjam, FDI in Pharmaceuticals & the widening gap of the government & the vast majority of Indian masses who are deprived of the basic healthcare needs. The highlight of the seminar was the panel discussion on “Ethics in Medical Profession” where country’s top doctors & industry debated on the decline of ethics in medical profession & reached at the consensus that the industry & doctors must work closely to build a strong models to promote the dignity of the profession.

Addressing the industry leaders & leading faces of the medical profession, Mayank Gandh, Chief Guest of the evening urged the industry to provide affordable medicines to the Aam Admis & criticized the government of not bringing industry friendly reforms. Mayank stressed the need of a clean politics & higher ethical standards of the rulers & launched a series of attack to the policy makers who underestimated the power of the Aam Admis. The arrogance of the legislators & Parliamentarians will no longer be tolerated as India is now prepared to give a befitting reply to the rulers if legislators failed to the demands of the masses.

The Evening Award ceremony was marked by the entry of the volunteers of the Aam Admi Party at the historic summit. Anjali Damania, Maharashtra State Convenor of the Aam Admi Party joined with Mayank Gandhi & Satya Brahma in the inaugural lamp lighting ceremony followed by the National Anthem in the packed house where the who’s & Who’s of the Indian healthcare industry were present. The Chief guest of the Pharmaleaders awards evening Mayank Gandhi accompanied by the Editor-In-Chief of the Pharmaleaders Satya Brahma conferred the prestigious & coveted titles to the leading faces of the Indian healthcare industry. The winners at the 6th Annual Pharmaceutical Leadership Summit & Awards are as following.

Voting Nomination Category Winners:

Rising Company of the year 2013
1. Galpha Laboratories Ltd.
Emerging Business Leader of the Year 2013
2. Dr Rajeev Modi
MD, Cadila Pharmaceuticals Ltd
3. Emerging Business Woman of The Year 2013
Ms. Nidhi Saxena
Founder & CEO, Karmic Lifesciences
4 .Dynamic Entrepreneur of the Year 2013
Mr. Prakash Guha
MD, Zuventus Healthcare Ltd
5. India’s Most Respected Company by Medical Practitioners 2013
Zuventus Healthcare Ltd
6. India’s Best Managed Healthcare Chain 2013
Global Hospitals Group
7. Multinational Company of the year 2013
Abbott India Ltd
8. India’s Most Admired Company in Healthcare IT Solutions 2013
Infinite Computer Solutions (India) Ltd.
9. India’s Most Respected Cosmetic Dermatologist 2013
Dr. Chytra. V. Anand,
Founder, CEO & Chief Cosmetic Dermatologist, KOSMORDEMA
10. India’s Most Admired Company in CRAMS Market 2013
Akums Drugs & Pharmaceuticals Ltd
11. Emerging Company of the Year 2013
Menarini India Private Limited
12. Women Entrepreneur of the Year 2013
Dr. Nilyini G, Founder CEO, Blu Skin Cosmetology
13. CEO of the year 2013
Mr. Rehan A. Khan
Managing Director, Abbott India
14. India’s Most Admired Company in Corporate Governance 2013
Aurobindo Pharma Ltd
15. Brand of The Year 2013
16. Rising Brand of The Year 2013
Newbona (Akumentis Healthcare Ltd)
17. India’s Most Admired Pharma Company 2013
Alkem Laboratories Ltd.
18. India’s Fastest Growing Pharma Company 2013
Menarini India Private Limited
19. India’s Most Respected Healthcare Group To Work For 2013
Emcure Pharmaceuticals Ltd
20. India’s Fastest Growing Company in Contract Manufacturing 2013
Akums Drugs & Pharmaceuticals Ltd

Non-Voting Category Winners :

1. Incredible Medical Expert of the Decade
Dr. Viswanathan Mohan, Founder & CEO
Dr. Mohan's Diabetes Specialties Centre.
2. Incredible Medical Expert of the Decade
Dr. Deepak Chaturvedi
Physician Endocrinologist & Diabetologist
3. Incredible Medical Expert of the Decade
Dr. Jothydev Kesavadev
Founder Chairman, Jothydev's Diabetes Research Centre
4. Incredible Medical Expert of the Decade
Dr. Shasank R Joshi
Consulting Endocrinologist & Founder, Joshi Clinic
5. Global Indian Of The Year 2013
Dr. Naresh Trehan
Founder Chairman, Medanta
6. Global Indian Of The Year 2013
Prof. Dr. Nandkishore Shamrao Laud, Founder, Dr Laud Clinic
7. Lifetime Achievement Award 2013
Mr. D.C. Jain, Chairman
Akums Drugs & Pharmaceuticals Ltd.
8. Pioneering Innovation in Stem Cell Banking Award 2013
Life Cell International Pvt Ltd
9. Entrepreneur of the year 2013
Dr. G.S.K. Velu, Managing Director, Trivitron Healthcare
10. Rising Brand of The Year 2013
Adroit Biomed Limited
11. Business Leader of the Decade
Mr. Satish Ramanlal Mehta, CEO & MD
Emcure Pharmaceuticals Limited
12. Emerging Hospital Group 2013
Medfort Maxivision Hospitals
13. Non-Surgical Aesthetic Medicine Expert 2013
Dr. Rashmi Shetty
CEO & Founder, Ra Skin & Aesthetcs
14. Healthcare Visionary of The Decade
Dr. Kancherla Ravindranath
CMD, Global Hospitals Group
15. Business Leader of the year (Healthcare & IT)
Mr. Upinder Zutshi
CEO & MD, Infinite Computer Solutions (I) Limited
16. India’s Most Admired Homeopathic Brand 2013
Dr. Batra’s Positive Health Clinic
17. Transformational Leader of the Decade
Dr. Mukesh Batra
Founder Chairman, Dr. Batra’s Positve Health Clinic
18. Emerging Pharmaleader of the year 2013
Dr. Rajaram Samant
MD, Akumentis Healthcare Limited
19. Emerging Pharmaleader of the year 2013
Mr. A.K.Patra
CMD, Salius Pharma Pvt. Ltd
20. Emerging Pharmaleader of the year 2013
Mr. A.K.Sahoo
CEO, Ozone Pharmaceuticals Ltd
21. Emerging Pharmaleader of the year 2013
Mr. Piyush Rathi
Director, Advanced Enzymes Technologies Ltd.
22. Pharmaleader of the year 2013
Dr. Hasit.B.Joshipura, MD, GlaxoSmithKline Pharmaceuticals Ltd
23. Social Entrepreneur in Mass Education Award 2013
Mr. Agnelorajesh Athaide, CMD, St. Angelo’s Professional Education.

To view the photograph, please click on the link given below:

Mr. Mayank Gandhi, Member National Executive, AAP & Mr. Satya Brahma, Chairman of Pharmaleaders Group honoring Awardees at the Pharmaleaders 2013 meet
Mark Peter / Chalapathy, Pharmaleaders, +91 9980285835 / 8722417287

          San Diego Landfill-A Wasted, Mostly Buried Resource        
This is the report I promised you back in December 2010. I might be more ashamed to be turning it in so late, were I not laden with multiple brain injuries and their attendant cognitive limitations, speech difficulties (fairly severe dysarthria which sometimes makes it difficult for me to talk clearly on the telephone or in dictating to my speech recognition software,), etc., perhaps I could have produced this report much earlier, even though I knew nothing of the subject matter. Basically, I am a medically retired former federal employee, who had time on his hands to research these wonderful relatively new waste management technologies, called conversion technologies (CTs). Still, given my lack of knowledge in Solid Waste Management, it took much longer than I thought it would, because I seriously misjudged the enormity of information I had to sort through/digest, starting with waste disposal and landfilling in general, and my trouble Goggling properly for the necessary information within the Environmental Services Department (ESD) San Diego City Government, plus finally, my own computer-based difficulties that are, I am sure, at least partly, a result of those brain injuries.

First, I'm not, nor have I ever had been, a Municipal Solid Waste (MSW) professional or a lawyer. Nor have I been a person employed in the fields of cultural affairs, naturalism, or a practicing labor economist. I am just a private medically retired city resident, who has only gotten my knowledge of this industry through Goggling various sources of information regarding waste disposal, and cities', municipalities', and waste management authorities' respective attempts to deal with their own MSW issues, and my own personal experience as a federal government employee user of waste disposal at one mass-burn Waste to Energy (WtE) facility.

Because some of these suggestions could be considered controversy or sensitive by some, I'm also sending this to Mayor Sanders, all other San Diego City Councilmembers, all in-County City Mayors and City Councils that I can reach via e-mail, and because it could affect the overall waste management plan for the County, all San Diego County Supervisors, most in-county and several out-of-county State Senators and Assemblymen, even though this is a redistricting year, as well as reporters and other MSW interested parties who can help do some reporting on this topic, and help sell the concept, not only for San Diego, but also for the rest of the state. Where used, URLs have been shortened using, a free URL shortening software product, that does not require downloading (the shortened link will automatically take you to the correct webpage).

Second, I recognize that there's been a lot of recent controversy regarding the possibility of contracting-out the city landfill function, and whether it was a contractable function, so I e-mailed my good friend from my days as the Security Director, Naval Ocean Systems Center, subsequently renamed, when the command's missions were redefined again, into the Space and Naval Systems Center, San Diego (SSC SD). During my 10 years of tenure there at NOSC/SSC SD as the Security Director from 1989 to my strep throat-induced medical incapacitation in 2000, we were frequently required to examine all of our internal functions for the possibility that those functions were not inherently governmental, and then if not, determine if the function could be contracted-out. This was part of the The Federal Activities Inventory Reform Act (FAIR), P.L. 105-270, OFPP Policy Letter 92-1, "Inherently Governmental Functions" (09/23/92).
Based on this type of periodic review, we had quite a few functional areas in the command which had been contracted-out, to include building sanitation (trash collection, floor sweeping and mopping, carpet vacuuming and occasional shampooing), grounds maintenance (grass cutting, general trash pickup, bush and tree trimming), waste hauling, a good portion of the command's software programming and related information technology (IT) services via the overall IT services contract, but also in my own Security Office, one IT contractor who helped program some unique, custom-developed software (which reorganized our locks and keys into some semblance of logical order), a major part of the badge and pass (employee/visitor badge and vehicle decal issuance) operation, classified document (documents which contained national security information) destruction, key and lock control, locksmith services (changing on a yearly, or on a as-necessary basis, combinations on security containers used to stored classified documents, the complete plant property triennial inventory, and all contact guard services. We also had thousands of contractors on-site, performing valuable research and engineering services, some of whom, in addition to having a security clearance and “a need-to-know” for the classified information on which they worked, were allowed to act as physical custodians of classified documents, as if they were permanent government employees on-site. These contractors all had security clearances and access to those selected classified documents to the security clearance level of their contracts, as a condition of employment, as part of their respective contracts. Given that the federal government was, in these cases, entrusting classified documents to contractors (individuals employed by private for-profit entities), as is routinely done when any federal classified contract is awarded for development or production of, say, the nation's most advanced fighter or bomber, all the way down, in terms of sophistication, to seemingly the most minor of classified services (like classified photography services or document duplication, for example) [admittedly though, through a whole different process, which is part of the overall Federal contracting process], I find it hard to believe that the city landfill function is an inherently governmental function. I believe these services are legitimately a function that could be contracted-out, as did my friend from work who was in charge of the Functional Review process in the command's Internal Review Office. Similarly, I see no “Inherently Governmental” distinction for the city employees performing the MSW curbside pickup services. In fact after a great amount of Googling the term “People's Ordinance of 1919”, I found the city attorney's ruling on this topic, confirming that, in response to the Environmental Services Department's question of whether the People's Ordinance of 1919 requires City employees to collect residential and small-business refuse generated within the City, thereby precluding the city from hiring private contractors to perform these refuse collection services. The short answer from the then city attorney, Mr. Aguirre, was “No”. As further confirmation of my recommendation in this matter, Reason Foundation's Local Government Privatization 101, in Table 1, shows that both waste collection and waste disposal are two of the top three services privatized to For-Profit entities, according to a survey preformed by the International City and County Management Association. In this same article, following a list of more than 15 potential service areas, says that “But more important, the question of "what can local governments privatize" is in many ways the wrong question to ask, as privatization is a policy tool that should be considered in most instances. A better question is "where can't local governments apply competition or privatization?." Virtually every service, function and activity has successfully been subjected to competition by a government somewhere around the world at some time. When asked what he wouldn't privatize, former Florida Governor Jeb Bush replied: "police functions, in general, would be the first thing to be careful about outsourcing or privatizing. This office. Offices of elected officials ... and major decision-making jobs that set policy would never be privatized.” Quoting from the article, “Governor Bush used competitive sourcing more than 130 times, saving more than $500 million in cash-flow dollars and avoiding over $1 billion in estimated future costs.” Furthermore, the California Republican Senate Caucus Study on Privatization, Briefing Report: Privatizing California's Local Governments, cites some interesting examples of city governments services that can be improved through privatization, and in the Infrastructure, Public Works, and Transportation section, says that:
“A decade ago, California voters approved Proposition 35, also known as the Public Works Project Act of 2000. This proposition granted local governments greater freedom to pursue partnerships with the private sector on infrastructure projects. As such, the infrastructure arena is amongst the ripest areas for employing a range of creative privatization techniques.”
Quoting from the first two paragraphs of Reason Foundation's Local Government Privatization 101 :

"It is not a government's obligation to provide services, but to see that they are provided."
former New York Governor Mario Cuomo

"Privatize everything you can."
Chicago Mayor Richard Daley (advice to an incoming mayor)

Manhattan Institute-This Works: Managing City Finances
, Authors William Eggers of the Manhattan Institute and Center for Civic Innovation Chairman Stephen Goldsmith, the former mayor of Indianapolis, outline the strategies needed to continue to reinvent urban governments; injecting competition into city services; making government performance-based; making use of information technology; improving asset and financial management; enhancing human capital; and creating institutions to drive continuous improvement.

And then there is every privatization advocate's Poster Children, that being “Privatizing City Hall: Sandy Springs and the New Georgia Contract Cities”, a subparagraph under Reason Foundation's Local Government Privatization 101 cites the following: “Sandy Springs, Georgia was the first. Fed up with high taxes, poor service delivery and a perceived lack of local land use control, 94 percent of Sandy Springs' nearly 90,000 people voted to incorporate as an independent city in 2005. What makes Sandy Springs interesting is that instead of creating a new municipal bureaucracy, the city opted to contract out for nearly all government services (except for police and fire services, which are required to be provided directly by the public sector under Georgia's state constitution). Originally created with just four government employees, the city's successful launch was facilitated by a $32 million contract with CH2M-Hill OMI, an international firm that oversees and manages day-to-day municipal operations. The contract value was just above half what the city traditionally was charged through taxes by Fulton County. The city maintains ownership of assets and maintains budget control by setting priorities and service levels. Meanwhile the contractor is responsible for staffing and all operations and services. According to Sandy Springs Mayor Eva Galambos, the city's relationship with the contractor "has been exemplary. We are thrilled with the way the contractors are performing. The speed with which public works problems are addressed is remarkable. All the public works, all the community development, all the administrative stuff, the finance department, everything is done by CH2M-Hill," Galambos said. "The only services the city pays to its own employees are for public safety and the court to handle ordinance violations." Sandy Springs recently successfully rolled out its own police and fire departments. Counting police and fire employees, the city of 90,000 has only 196 total employees. Nearby Roswell, a city of 85,000 has over 1,400 employees. Furthermore, Sandy Springs' budget is over $30 million less, and by most accounts provides a higher level of service.

The "Sandy Springs model" seems to be gaining steam. The city's incorporation was perceived as such a success that four new cities—Johns Creek, Milton, Chattahoochee Hills and Dunwoody—have been formed in Georgia since 2006 employing operating models very similar to Sandy Springs (though severe revenue shortfalls in 2009 prompted the two smallest to scale back their contracts). And in 2008, city officials in the recently incorporated Central, Louisiana (population 27,000) hired a contractor to deliver a full range of municipal services—including public works, planning and zoning, code enforcement and administrative functions—as part of a three-year, $10.5 million contract.
Sandy Springs and other contract cities demonstrate something very powerful from a public administration standpoint: there's hardly anything that local governments do that can't be privatized, so there's no reason policymakers shouldn't think big on privatization.”

Perhaps most importantly with respect to MSW, NSWMA-Privatization: Saving Money, Maximizing Efficiency, And Achieving Other Benefits in Solid Waste Collection, Disposal, Recycling fully explores why MSW privatization is perhaps the best choice for most local governments. Finally, Reason Foundation's Annual Privatization Report 2010: Local Government Privatization provides on page 12, an update on San Diego's attempt to implement the result of the approval of Proposition C in 2006 and the resounding defeat of Proposition D in 2010, of which you are well aware. Part 9 of the same document, page 28, details the latest update on the solid waste and recycling privatization efforts around the country.

But I digress, as privatization could be its own separate report.

Perhaps San Diego's current landfill and all associated municipal solid waste (MSW) issues initially began, I believe, when the city voters passed the People's Ordinance of 1919, by an astounding a 85%-15%,which established a precedent of offering no-fee residential trash collection service. The City's own Environmental Services Department (ESD) Collection Services webpage says that: “the city of San Diego has been providing trash collection services to the public over 90 years” effectively saying that the ESD has been responsible for all MSW collections since the law was passed in 1919. Changes to the system have been proposed at least twice during the last two decades, but voters have decided to pretty much leave things as they are now for residential households. Certainly, the best summary of this situation can be obtained by reading the City Attorney's Memorandum of Law of 16 July 2010 to the Mayor and City Councilmembers. Earlier, the KPBS video of 31 July 2009, entitled Free Trash Collection Could End for San Diego City Residents articulated the idea that free trash collection to residential customers in the city is not the norm in city government around the state or even the county and is considered the “Third Rail” in local City politics, splitting City Councilmembers, because they fear the anger of voters if they support additional taxes to cover this cost, rather than continuing to charge the General Fund for these services, and that charging residents a fee to cover this is the only fair means of avoiding using the General Fund for this cost.

I personally tend to side with Judge Larry Sterling (retired) when he says that, in response to comments regarding free trash pickups for property owners:
On the “free” trash collection issue, all property owners are paying their property taxes and a portion of those taxes were specifically designated for trash pickup via the “People's Ordinance” adopted by initiative in 1919, a direct order from the public. The voters did not command the birth of the dysfunctional Historic Site Board, or the Planning Department, the Development Department, subsidies to the San Diego Unified School Districts babysitting program, or even the Library Department. They did command the creation and operation of the trash pickup and for perfectly good public health and safety reasons. The voters of San Diego wisely wanted all trash picked up and disposed in a uniform and timely manner. Charging double for trash pickup guarantees that those who operate on the financial margins will dump their trash in nearby canyons, on vacant lots, and along our roadsides. There they will become unsightly fire and public health hazards. And much more expensive to pick up. Not only that but the people the mayor is proposing the double charge are already paying for their own streets. Does the mayor want all those streets deeded to the city? Although Judge Sterling did not directly say so, this possibility of trash being deposited in canyons, vacant lots, or along roadsides, is what is known as an unintended consequence of any potential changes to the law!
Judge Sterling continued:
The citizens pay into the general fund therefore there is no such thing as “free trash pickup.”
It is true that the lazy, sorry city amended its own ordinance some time back to prohibit additional “hold harmless” agreements to go off the public right of way to pick up trash. Who knew that? Probably passed on the consent calendar and done without fanfare or wide notice.
It is also not correct to say that the city is not required to pick up that trash. The city is not REQUIRED TO GO ON THE PRIVATE PROPERTY to pick up trash absent a hold harmless agreement. The city is still required to pick up the trash if the resident takes it to a public street.
Where are the savings exactly?

And nearby homes will suddenly find the streets in front of their houses crowded with dozens of trashcans from nearby “private” streets from which the trash has been collected by the city for over 70 years.
It is a sad thing to travel through San Diego and see the streets unrepaired, the traffic islands filthy, dilapidated and abandoned news racks trashing our sidewalks, unpainted city light poles, traffic signals that are not operating, and the city parks and other buildings ill maintained. There are fifty major reforms that I can think of myself that would save the city money or increase its income rather than abandon its basic health and safety duties like picking up the trash.
Given correct management and mayoral leadership, city staff could be driven to do more for less, not less for more. That is exactly what every other enterprise has to do to survive. Why are the city managers exempt from such exertions?

DISCLAIMER: As anyone who writes on a given subject, I will admit to a few biases. First, as most of my former work colleagues will tell you, I have a strong inclination towards using streamlining and technology as a means of solving problems in government, at least the portion of government of which I am most familiar (federal). My second bias is based on my service to the U.S. Navy as Security Director of SSC SD, mentioned above, where I was ultimately responsible for, among other things, the lifecycle management (management, annual inventory and destruction) of all classified (Confidential, Secret and Top-secret) general security classified documents and suddenly inheriting 13 thousand pounds of classified computer hardware (multiple-platter hard drives and other data-retaining electronic devices) when the Anti-Submarine Warfare Department shifted all their classified computer processing off of older Digital Equipment Corporation-brand mini-computers and the Security Office had to dispose of that equipment. Because the command had previously been almost solely concerned with tens of thousands of classified paper documents, and had consequently been using disintegrators (large machines with multiple spinning rows of knife blades which cut paper into very small particles) to destroy all these classified paper documents, and having no readily available method of destroying metal or other classified hardware, and acting on a tip from a former supervisor of one of the previous classified destruction contracts, we contacted the Plant Manager for the City of Commerce, CA WtE facility, who after hearing what we were looking for, readily agreed to accommodate our need for personal verification of hardware destruction. I and a couple of my security supervisors loaded two trucks with box after box of this heavy hardware/material and proceeded to drive to the plant. Following a demonstration of the plant's capabilities for emissions monitoring (I was and still am concerned with our air quality and the environment), we proceeded to dump some of the hardware into the available charging shoot, which led straight to the plant's furnace (federal security regulations do not allow one to simply dump classified material into an open pit and merely hope for a later claw pickup and burning in the furnace, like one usually does with MSW). After a nice long break to check whether the emissions monitors had spiked (which of course they hadn't significantly moved), and being reassured by the plant manager that this was not unusual (he intimidated that we were not his first customers requiring classified destruction), we just started dumping the computer hardware in as fast as we could carry it to the charging shoot. This classified material/hardware destruction effort was so successful, that we subsequently modified the command's entire classified destruction contract to eliminate the disintegrators as government-furnished equipment and, when asked by the potential contract bidders, told them that we had recently used that City of Commerce WtE facility as our disposal site. The successful bidder of the subsequent contract re-award also bid to use this City of Commerce WtE facility, not only saving the command significant money but also allowed the command to permanently shut-down the disintegrators and associated bailing machine which had been fouling the area both inside and around the building where they were housed with extremely fine paper dust particles, really too small to capture or preclude from being generated, from a practical standpoint.

Fast forward to 2008, after my strep-throat-induced series of brain injuries, resulting in my forced medical disability retirement, when I read either an environmental blog or Science Daily article on a waste-to-energy technology involving IST Energy's Green Energy Machine (GEM) technology and how this CT was being used in Boston, MA to power an entire office building using the buildings' own waste, admittedly mostly paper (although I believe the technology has been further improved and commercialized from when I first saw it). The thought of a possible CT operation dealing with San Diego's MSW while also possibly offering a closer site for the classified disposal requirements of SSC SD, (although I was medically retired from that Point Loma Research and Development facility) got me working somewhat more aggressively, hoping to find a way in which to effect this. During your 2 May 2009 community meeting in Scripps Ranch, I noticed that one of your priorities in the City Council was greater efficiencies in the ESD for curbside MSW pickup, so I notified Ms. Batten, your Scripps Ranch field Representative, of my admittedly limited knowledge on the subject of CT, but subsequently e-mailed her with the information I had read, and proceeded to both attempt to gain additional information on the subject matter, and even attempted to set up a meeting date with Mr. David Montella, then InfoSciTec (IST) Executive VP, Technology Solutions, now IST Energy, who was already going to be in San Diego on 8 October 2009 for other business, if we could meet at my house (rather than looking for another meeting site, which would have required transportation for me (having lost my license to drive a car because of my brain injuries) and anticipating the need for several attendees, both from your staff, potentially from the staff of Congressman Duncan Hunter (admittedly looking at the possibility of a federal grant for a demonstration project), as well as the City's Environmental Services Department (ESD). I also ended up inviting representatives of Visiam as well as Startech Environmental Corporation (Startech) . Unfortunately, neither of the three companies representatives could attend, nor could representatives of the ESD, your office, or Congressman Hunter's office. My guess is that because I had clearly signed each e-mail to these respective companies with a statement which admitted that I had absolutely no authority in the matter, but was only a concerned citizen, likely led the companies to write-me-off as a dead-end business lead. Later, Ms. Dolce of Congressman Hunter's field office was tasked with following-up to see if any significant activity had occurred or any plans have been made during the meeting. I had to admit to her via e-mail, that no meeting had taken place, but I had received a call from the West Coast representative of Startech to extol the virtues of their gasification solution, and how much cleaner electricity from gasification was compared to coal burning, just before her (Ms. Dolce's) call to me.

Not one to casually admit defeat, I started contacting all of the other CT providers I could find around the country in an attempt to try to determine which one was best. Some of those companies I contacted included W2 Energy Corporation, Waste2Tricity, ILS-Partners , which has now partnered with Pyromex Group, and looked at the CT offerings of S4 Energy Solutions (a collaboration of Waste Management, Inc. and InEnTec, [a spinoff of technology developed jointly by the Massachusetts Institute of Technology (MIT) and the Battelle-operated Pacific Northwest National Laboratory (PNNL)] , EnerSol Technologies, Inc., Westinghouse Plasma Corp..(a division of Alter NRG Corp), Jacoby Group Geoplasma, and contacted several integrators of these thermal conversion and anaerobic conversion technologies, both in the US as well as in Europe. I found the AITKIN COUNTY, MN PLASMA GASIFICATION STUDY assessment of whether to move forward with a full feasibility analysis regarding a potential CT solution in the International Falls, MN area. Subsequently, I also discovered Fulcrum Bioenergy , with whom Waste Management has now entered a strategic partnership. and Sun Energy Group LLC In total, I literally spent 3 yrs. (admittedly part-time, as a brain-injury person trying to perform other household tasks) reviewing the history of waste disposal from the basic of burn cans in one's backyard (as I had experienced with paper/cardboard growing up), vacant lots dumping, county dumps, cities and waste agencies as diverse as New York City; Puerto Rico; St. Lucia County, FL; Hawaii; Los Angeles city/county; Santa Barbara city/county, and reviewed various references on the subject, feeling like I should have earned at least an Associates degree in Solid Waste Management, if it exists. It was about this time that I realized that the City of San Diego was broke, and really unable to purchase or invest in any equipment, even if such investment would help solve the MSW situation. The response to one of my many inquiries, from Plasco Energy Group, referred me to an international competition held by the Salinas Valley Solid Waste Authority (SWSWA), in which the authority had already begun to study the potential for CT of MSW starting in 2005, apparently when the communities that make up the Authority resisted further landfilling. I found the Authority's entire process of looking for a public-private partnership for MSW destruction, establishing a Conversion Technology Committee (CTC) to recommend long-range diversion goals, it's two-phase approach to contracting for such a solution (first, a Request for Qualifications, [RFQ]), and then a Request for Proposals (RFP), to be very instructive. Also, the CTC actually took field trips to selective/referenced MSW CT sites around the world to witness firsthand those operations (pages 7-28 of HDR's slide presentation). In looking at some of the proposals for the SWSWA, led me to Urbaser S.A , EBARA-TwinRec Gasification and Ash Melting Technology, a Japanese CT technology which has been used in several applications in that country as well as Interstate Waste Technologies and Entech Industries . Subsequently, I also discovered PyroGenesis Canada, Inc. a CT firm which has recently been awarded a contract with the U.S. military, Recovered Energy, Inc. , WPP Energy Group , Ze-gen , Zeros, Global Energy Solutions, Bull Moose Energy, FutureFuelCorp.

Also, Mr. Mathews, SWSWA General Manager/Chief Administrative Officer and his staff, particularly his Diversion Manager, Ms. Susan Warner, were very helpful and tolerant of my incessant calls and e-mail questioning on how they achieved what they did. I believe that CA State Sen. Anthony Cannella and CA Assemblyman Louis Alejo, can be very proud of the work that SWSWA has achieved, in setting a standard for the rest of California to strive for.

The city of San Diego's planning for future MSW handling was the hardest for me to find, as its name didn't initially seem to apply. The Long-term Range Management Operational Strategic Plan (LRMOSP), put together with the assistance of Bryan A. Stirrat and Associates (BAS) lays out many waste diversion options for the City. Similar to the SVSWA's CTC is the establishment of a Resource Management Action Committee (RMAC) which is tasked with recommending short-term and long-term diversion goals. I was able to find minutes from RMAC Phase I meetings 1 through 5 on the Web, but nothing since. So if further decisions have been made since then in Phase II, I'm not aware of them.

Center on Policy Initiatives OnlineCPI's Petition titled KEEP MIRAMAR LANDFILL PUBLIC argues that “Turning the public's business over to private operators-whose goal is profit rather than the public good-puts quality and safety at risk and often cost the community much more in the long run” and continues later with “There are significant risks in operating the landfill for profit, rather than for the public good, including environmental damage, added expenses and the loss of community services funded by landfill revenue.” I personally believe that with proper contractural monitoring and oversight, landfilling (what is left of it, when CT is applied to the MSW) can not only be safely done by a qualified CT contractor while also benefiting the public sector (San Diego) financially.

As far as the landfill itself is concerned, Online CPI:Miramar-A Public Asset that benefits all San Diegans, states that the Miramar landfill brings in about $6 million more than it cost to operate, and that these surplus funds pay for vital services in other/related areas. However, the report of the Grand Jury of 2008-2009, Time for Repeal of the People's ordinance of 1919, would seem to imply that the cost to the city's General Fund for all Municipal Solid Waste(MSW) curbside pickup and disposal in the landfill is in excess of $50 million/per year, if not greater. However, how much of that cost is related to operation of the Miramar landfill itself is not defined.
But, the financial analysis performed by BAS, as part of the city's LRMOSP, chapter 4.3.1, says “For 2009, the annual budgeted expenditures in the General Fund are $40.5 million. The General Fund portion of the ESD funding provides for weekly residential refuse collection, refuse container management, underground tank management, asbestos and lead management, hazardous materials, and other related services.”

Furthermore, chapter 4.4.4, Overall Financial Picture, of the LRMOSP says that in summary, “While the city has implemented cost-cutting measures and increased efficiencies to extend the lives of the funds. However, given the overall trends of the funds, the success of recently implemented waste reduction and diversion efforts, and the impacts of the economic crisis, the Recycling Fund is currently projected to be in a deficit in Fiscal Year 2010, and the Refuse Disposal Fund is currently projected to be in a deficit in future years.”

So in summary, it appears that the landfill is far from a moneymaker, and is in fact, is a significant drain on the General Fund, which will only increase over time. Unfortunately, the waste reduction and diversion efforts implemented by the ESD, while probabl important for the environment and potentially lengthening the life of the landfill, have only made the landfill less financially self-sufficient.

Sierra Club San Diego Chapter in their letter on privatization of the landfill, addresses several potentially important issues. Not being qualified to review all of these legal citations, I will have to leave their letter to the City attorney to decide what is correct, but I believe that both the Online CPI and Sierra Club documents miss the major point of discussion, and that is, in spite of using the best landfilling processes available, like making the landfill more dense by compacting it to industry standards, using full cost accounting on an as-needed basis to determine ESD expenditures, using alternate daily covers, leachate recirculation, achieving International Standards Organization (ISO) certification, the city is still rapidly running out of landfill space in Miramar's West Cell, and with no other city-owned landfill to which we can retreat, city residents will likely be forced to start paying for their waste disposal at distant, and more expensive, non-city-owned landfill sites, even though tax increases which had been proposed in the past, have been soundly defeated, I believe a different tact is necessary to continue disposing of our MSW. The situation seems even more bleak when one considers that as the local economy recovers, total MSW will likely increase in volume. The key to reducing this volume, I believe, is as BAS has indicated in the LRMOSP, is the use of CT to drastically reduce the massive volume of MSW currently destined for the landfill.

I also contacted Dr. G. Fred Lee, of G. Fred Lee & Associates, a noted authority on landfill sitings, risks,and inadequacies and, and when asked: ”What I'm interested in knowing is whether applying any of the various current MSW conversion technologies available (biological or thermal conversion, or even older waste-to-energy [WTE] solutions), in your mind, has any significantly less negative impact on the environment following this conversion when disposing of the remains/non-salable product into a landfill? As and admitted untrained observer/novice, I tend to believe that such conversion might go a long way towards minimizing any deleterious effects on the environment. “ Dr. Lee responded with this: ”These MSW conversions approaches can be conducted with little or no impact on the environment/public health. However the siting and operation of these technologies with full environment/public health protection make them far more expensive than the typical Subtitle D landfilling as allowed today in California and under the US EPA regulations. The basis issue is that the politics are such that administrations are unwilling to cause the public to experience paying double to triple the cost of MSW management.”

The presentation “Health Risk of Landfilling Versus Combustion of municipal solid waste: An Illinois Comparison”, of which Drs Lee and A. Jones-Lee co-authored work was referenced, the abstract states in part “Risks of either technology [landfilling versus combustion] fall within the regulatory precedents for acceptability during the operational phase (30 years) and the early closure phase (40 years), but the ultimate releases of leachate from the landfill generate potentially large risk over time interval beyond this horizon.”. This statement would seem to indicate that, in the long run, the choice between landfilling versus combustion is an easy one in favor of some form of combustion.

Even the 2006 National Latino Congreso Resolution 3.15 (Floor Submission)-- Conversion Technologies and Zero Waste resolved that:

WHEREAS, The California Integrated Waste Management Board indicates that over 40 million tons of waste are land filled every year just in California, despite a 50% recycling rate; and

WHEREAS, landfill space is at a premium and disposal rates are estimated to increase; and

WHEREAS, the siting of landfills and solid waste disposal facilities is a major Environmental Justice issue, and eliminating the need for disposal reduces the impact on communities with nearby disposal facilities impacting their quality of life; and

WHEREAS, conversion technologies are processes capable of converting residual post-recycled solid waste and other organic feedstocks into useful products, alternative fuels, and clean, renewable energy, and offer strategic energy, economic, social and environmental benefits; and

WHEREAS, biofuels derived from solid waste and excess biomass via conversion technologies and can be a clean, renewable fuel source that reduces our dependency on fossil fuels; and

WHEREAS, the use of conversion technologies can contribute solutions to California's critical waste disposal and environmental problems, and result in substantial environmental benefits for California, which include reducing the amount of waste disposal in landfills, production of renewable energy, and reduction of air emissions including greenhouse gas emissions; and

WHEREAS, conversion technologies can create "green collar" jobs with good wages and benefits through increased private investment;

1. Support the enhancement and expansion of waste reduction and recycling programs nationwide, and the adoption of zero waste goals to eliminate the concept of waste;

2. Conserve natural resources and reduce the amount of hazardous materials in the waste stream by supporting and promoting preferable purchasing programs, product redesign, advanced disposal fees and other manufacturer responsibility measures as well as enhanced collection and recycling infrastructure;

3. Urge state and local communities throughout the country to invest in landfill alternatives, such as conversion technologies, which create "green collar" jobs and make use of abundant biomass and organic waste resources in an environmentally beneficial manner; (emphasis added)

4. Lobby lawmakers at the State and Federal level to provide clear permitting pathways for the development of conversion technologies, and properly define and incentivize the development of these technologies based on sound science ad their life-cycle environmental impacts and benefits in relation to other solid waste management options.
In looking around the state for evidence of other waste disposal issues, the article BioEnergy Producers Association-AB 222 Gutted by Senate Environmental Quality Committee states that five Democrats on the Senate Environmental Quality Committee yielded to "environmental" opposition orchestrated by lobbyists for the traditional waste industry, and stripped the bill of its RPS [renewable portfolio standard] and landfill reduction provisions--the two major elements necessary to finance the construction of these projects. During the following week, the Committee's staff published further amendments that would have made it even more difficult to permit and operate these facilities than it is under existing statute.
The Bioenergy Producers Association report titled “California's Waste Conversion Technologies-Ensuring an Environmentally Clean and Abundant Future states "the Bioenergy Action Plan was created years ago and was available for review yet nothing has changed or have been done." So Senators Joe Simitian, Fran Pavley, Lori Hancock, Ellen M. Corbett, and Alan S. Lowenthal,(your names were the only ones on an old Facebook page, which incorrectly compared CT to incineration [a technique that the Global Alliance for Incinerator Alternatives (GAIA) has been known to subscribe, regardless of the science that shows otherwise] so it would appear that you are the members of the Senate Environmental Quality Committee who defeated AB 222). As intelligent as I assume you are, how could you possibly fall for this sophomoric and shallow rhetoric delivered by the Californians Against Waste (CAW) when they address the issue of Conversion Technologies, and say that “Conversion Technologies do not “Recycle”. I have read AB 939 and other related legislation, and I cannot find any wording that mandates that recyclers must sell their recycling residue (scrap aluminum, glass, metal) to manufacturers of such initial products.*

Insert something saying that Eight Great Myths of Recycling shows that
To suggest that they must would seem to impose a business model on the beverage industry that was rejected in the 1960s. Furthermore, this seems to impose a completely different standard on the state's recyclers, whereby they are not allowed to seek the highest price for their recycled products.

In fact, the Executive Summary of the Draft Conversion Technologies Report To the Legislature of March 2005, at the board meeting of 15-16 March 2005, Agenda item 23, Attachment 1 says: ”Visualize millions of tons of yard trimmings and wood that cannot be composted, of low value paper and plastic residuals from material recovery facilities (MRF) for which there is no recycling market demand, and of agricultural residues that can no longer be burned in the fields. All of these materials are either landfilled today may be headed for landfills tomorrow. Now imagine a future where unwanted materials destined for landfills instead are converted into high-value products such as energy, ethanol and other fuels, and citric acid and other industrial products. That future could revolve around a new generation of “conversion” technologies that have potential that help solve vexing environmental problems and could help achieve California Environmental Protection Agency's Strategic Vision and goals, including continuous improvement and application of science and technology and ensuring the efficient use of natural resources. ... The California Integrated Waste Management Board (CIWMB) has been researching conversion technologies because, although California has achieved a 47 percent statewide diversion rate and has a current composting infrastructure that processes 10 million tons annually, more than 39 million tons of material was disposed of in landfills in 2003. Of the amount disposed of in landfills, nearly 80 percent is organic material (paper, wood, green waste, food waste, etc.)”

Later on in the Environmental and Public Health Impacts section, page 33, the following information is provided: “While biological processes have gained widespread acceptance for various feedstocks,thermochemical processes have met with resistance from the environmental community and the public. Some of this resistance has stemmed from the perception that pyrolysis and gasification processes are variations of incineration. Some commenters have stated that federal law includes gasification and pyrolysis as part of the definition of incineration. ... The federal definition does not include gasification or pyrolysis. According to the University of California researchers, thermochemical conversion technologies differ widely from incineration in several key respects: the volume of output gases from a paralysis reactor or gasifier is much smaller per ton of feedstock processed than an equivalent incineration process. While these output gases may be eventually combusted, the alternative processes provide a intermediate step where gas cleanup can occur. Mass burn incineration is limited by application of air pollution control equipment to the fully combusted exhaust only....
Today the level of dioxin air emissions from combustion of MSW in the US has decreased from 8900 g-TEQ per year in 1987 to 12 g-TEQ per year by 2000, a decrease of 99.9 percent. The MSW combustion industry represents less than 1 percent of the dioxin/furan (emphasis added)

I ask you Senators, why didn't you at least publicly challenge the authors of the draft UC Riverside study on CT, on their study conclusions and opinions on why California should not be pursuing these CT opportunities, as part of the overall statewide RPS goals and landfill reduction provisions before choosing politics over hard science conducted by the state's own university system?

I can only assume that you have become enamored by the idyllic nature of the The Story of Stuff but before you pat yourself on the back, you should read a four-part critique of Ms. Leonard's work starting here. For those who believe that recycling is a noble goal, you should read the Eight Great Myths of Recycling . Furthermore, Dr. Milton Friedman, our nation's Nobel prize-winning economist, further destroys some of the basic tenets of Ms. Leonard's thesis regarding capitalism's effect on native peoples as he shows why people everywhere will strive for freedom and prosperity in this video Freedom to Choose.

As the Draft CA Integrated Waste Management Board Conversion Technologies Report to the Legislature, February 2005, Executive Summary says: “Thermochemical Conversion Technologies are technically viable options for the conversion of waste streams, including post-recycled municipal solid waste (MSW). This conclusion is based on the peer-reviewed information from the Evaluation of conversion technology processes and product report prepared by UC Riverside and UC Davis, the Life Cycle and Market Impact Assessment of Non-combustion Waste Conversion Technologies prepared by RTI International, and the independent evaluation of emissions from dozens of facilities worldwide. Thermochemical conversion technologies possess unique characteristics that have potential to substantially reduce the amount of material that is landfilled.” *Similarly, the Conversion Technologies Processing Municipal Solid Waste and Biomass, Final Report June 21, 2009 concludes with “Independently verified emissions test results show that thermochemical conversion technologies are able to meet existing local, state, federal, and international emissions limits. Today, there are advanced air pollution control strategies and equipment that were not available even 10 years ago. It is obvious from the results that emissions control of thermochemical conversion technologies is no longer a technical barrier. That said, it is recommended that facilities and agencies provide both continuous and periodic monitoring to keep the public informed and ensure ongoing compliance. Thermochemical technologies can process a wide variety of feedstocks than biological processes, and can have a greater effect on landfill reduction. Thermochemical technologies can also produce a larger variety of products than incineration, which can displace the need for non-renewable traditional sources of energy and fuel. Other indirect effects include eliminating diesel fuel truck trips and reducing landfill gas emissions.”

According to the UC-R Issues Report on Thermal Conversion Technologies, ...“Currently California is annually landfilling approximately 35 million tons of MSW. When factoring in the substantial decrease in waste generation resulting from the recession, the progress in recycling has been totally offset by population growth and increased per capita disposal.

It is unrealistic to believe that the post-recycled fraction of municipal solid waste that is being placed in California’s landfills can be significantly reduced through source reduction, traditional means of recycling and composting alone.

The state’s population is expected to grow by some 10 million people over the next 25 years. If the legislature fails to achieve final passage of AB 222, California will landfill more than one billion tons of municipal solid waste during that time--and a major opportunity to advance energy independence, reduce AB 32 GHG emissions and advance the production of Low Carbon Fuels will be lost.”

But, perhaps you were merely persuaded by the zero-waste advocates to defeat this effort to handle our existing MSW problem in the state. Personally, I can't tell you how many old toothbrushes I threw-away in my youth because I had no more need for yet another shoe polish welt brush.
But as Mr. Rick Brandes, formally of the US EPA, said at the Cooperation, Not Conflict: Municipal Solid Waste Management in the 21st Century in March-April 2010,

“Having recently retired after 31 years working on waste management regulations and policy at the US Environmental Protection Agency, I’d like to voice a massive frustration on the state of municipal solid waste management policy in this country.
In one camp are the “zero wasters.” They see a world where real integrated materials management means all
materials are contained in a continuous use/reuse cycle: organics to composting and soil enhancement, recyclables returned to use either in closed or open loop recycling systems, metals and glass back to new metals and new glass, and paper back into paper. They see the public as ready for a massive change to a more sustainable lifestyle, trashwise. And, incineration is viewed as the enemy of zero waste, not a complement.

In the other camp are the “energy recoverers.” They see a practical, realistic world, where real integrated materials management is driven by market forces, where recycling occurs when it makes market sense and energy is recovered from the bulk of the remainder of the non-recyclable municipal wastestream through mass-burn incineration or advanced thermochemical conversion. They see it as a decision on whether to landfill or recover energy, not whether to incinerate or recycle. They see the public as most likely to do what they are currently doing—and that doesn’t include a big change in lifestyle, trashwise.
It’s not like there are no alternative strategies. There are many, many ways to beneficially use this trash mountain of ours. Augment soil. Generate power. Make paper and save trees. Reduce bauxite mining. Recover even more metal out of the ash. Make park benches and roads. Produce ethanol and biodiesel. Use all alternatives where they make sense. Use different waste management strategies in different places. Do more of some of these things in some places and less of them in other places. But don’t editorially gun people down when they don’t do what you think they should do. Give communities the best available information, and they will probably do what is best for them. Let them make their trash more valuable.

About the only thing we can say right now is that there exists a massive lack of consensus on what constitutes an effective integrated materials management strategy. That has to change.”

Even former Gov. Schwarzenegger said the following in apparent agreement with Mr. Brandes'
position regarding available means for handling waste
“Environmentalists must stop letting the perfect become the enemy of the possible.”
- Governor Arnold Schwarzenegger

State Sen.Pres. Pro Tem Daniel Steinberg, I know you're a better man than the letters referenced in this blog, would indicate, sir. As California State Sen.Pres. Pro Tem, I believe that your office should have the goals and needs of the entire state in mind when taking action, yet your office could have greatly reduced the opportunity for CTs to be employed at the SVSWA by submitting those letters. May I very respectfully suggest that, if you have not done so already, please retract these letters submitted on your behalf by Kip Lipper, as it would appear to a layperson, that your office is trying to reinterpret the regulations that specifically carve-out MSW gasification as a qualifying renewable energy technology, and such duplicitious at the least, or at it's worst, Machiavellian behavior may lead California citizens/voters to think that you do not support the Global Warming Solutions Act of 2006,(AB 32) .Perhaps you should consider shortening your leash on Mr. Kipper, to avoid further such problems.or it's further implementation for land-use planning, as you have been advocating doing here, here, here.
Quoting portions of the letter from Mr. Roberti, President of the Bioenergy Producers Association, and a former Senate President Pro Tem himself, to you, ”Does it makes sense for this state to continue to place 35 million tons of post-recycled waste in landfills every year, when they could potentially support the in- state production of 1.6 billion gallons of ethanol and 1250 MW of power? Of course not.”
The logic of utilizing our post-recycled waste streams as a feedstock for renewable energy production is so clear and universally recognized, everywhere but in California, that the short-sighted view of a minority of members of our party is already becoming the subject of ridicule.”
When I asked Mr. Mathews of the SVSWA: “Since Salinas Valley have become the CA leader in the move towards better MSW management, might the SVSWA be willing to help create and lead a state-sanctioned group on MSW management, CT legislation, etc., if commissioned by the Governor on a pay-as-you-go basis for meetings/telephone/videos setups, etc.? (In my former life [pre-brain injury] as the Security Director of the major Naval full-spectrum R&D laboratory here in San Diego, I was lucky enough to be invited to join a group of security professionals which reviewed all types and kinds of security issues at our respective research laboratories and engineering centers. We met face-to-face twice a year at a member facility whose director would give the group a tour and a location to sit down to discuss our issues for a couple of days. This went on for several years and I found it very beneficial.) With current video teleconferencing technology, face-to-face meetings could be obsolete, or at least unnecessary. I would hope that sometime in the future, San Diego would be able to benefit from such a regular/periodic meeting of like-minded MSW professionals. Mr. Mathews responded as follows: “We would be interested in forming a working industry group to discuss and advance new waste management technologies. “
Perhaps as possible recompense for seemingly abandoning the state's CT advocates, so to speak, Sen.Steinberg might you consider sponsoring no-cost legislation whereby Governor Brown designates the SVSWA, the County of Los Angeles, or City and County County of Santa Barbara, as the initial head of a working industry group, perhaps titled the “California Conversion Technology Working Group” (CACTWG) and that such working group members pay their own expenses for establishing needed video teleconferencing equipment and such, and that the working group only be required to report to the California Energy Commission (CEC) once or twice a year on its meetings and such. I would suggest that, initially, that these three entities be designated as members, and that other waste management associations of cities/counties be included at the discretion of the Working Group head until formal meeting rules have been established.
Also in talking about the Global Warming Solutions Act of 2006,(AB 32), why are you, Assembly Speaker Perez, and Gov. Brown continuing to push it, and continuing to further the destruction of the California economy. I was intending to highlight how Eric Bays,a University of Oregon student, prepared a document A Logical Argument Against Man-Made Global Warming For the Layman, laying out in his conclusion on page 32 (that even I can understand) that “1) the IPCC is a political body, not an objective scientific body. It's conclusions are untrustworthy. 2) There is still scientific debate about global warming.3) Computer climate models are unreliable. 4) Earth's temperature has been warmer in the past. It is not hotter than normal. 5) Changes in energy from the sun drive climate change on Earth, not carbon dioxide. Therefore, global warming has not been proven.” I was also going to refer you three to The Great Global Warming Swindle. Even Reason Magazine, a nonpartisan research body, produced a report titled Misled on Climate Change-Policy Study 399, the Executive Summary, on the first two pages, details how there is an internal contradiction in the IPCC's own claims. The contradiction is over whether poor countries will suffer greatly from global warming or if they will be much better off than they are today, because apparently both claims are asserted in the IPCC report. But I'm afraid I'm probably too late to make a difference, because if Gov. Brown hasn't taken to heart California Watchdog's numerous articles on global warming such as Study Discredits Global Warming, AB 32 , which details the Climategate fraud. Maviglio Eclipses Global Warming Logic discusses when Democratic strategist Steve Maviglio took to using the Ad Hominem fallacy attack against Dakin Sloss, President of California Common Sense, an open government, nonprofit organization brought into a press conference to defend Assemblyman Anthony Portantino, against charges that the assembly had manipulated budget numbers to make him look bad. Maviglio accused Sloss of, among other things, of being a “climate change denier”. As John Seiler so systematically summarized following his discussion of the latest Climate Warming Refuted and following with Climate Warming Laws: “If we have any sense, we'll repeal all of the legislation that's based on man-caused global warming, beginning with ex-Gov. Arnold Schwarzenegger's AB32, the Global Warming Solutions Act of 2006. That's its actual name, before the “global warming” propaganda was changed to “climate change” It mandates draconian reductions in greenhouse gas of 25 percent by 2020. It's killing 1 million jobs. No wonder California's unemployment rate is 12 percent, almost 3 percentage points higher even than the dismal US rate. And earlier this year, Gov. Jerry Brown made matters even worse, by signing into law a mandate that renewables must comprise 33 percent of electricity production by 2020.” After discussing the text of state Sen. Joe Simitian's bill, SBX12, Mr. Seiler goes on to say ”California probably will be the last place to give up the man-made global warming – excuse me, “climate change” -- superstition. It's especially popular among Simitian's billionaire Silicon Valley constituents, who fund most of the state's politics....”
          Affordable Health Care? Facts, Opinions, and a Solution!        

Disclaimer: I am not a financial wizard, or a financial analyst. I sold health insurance for six months or so but that was 35 years ago. I do work for a company in the
business of health care but we distribute supplies so we get paid no matter how this goes. Finally, these thoughts are mine and mine alone. I’m just a concerned citizen who scratches his head at the folly of our legislature debating Health Care and various acts they want to repeal or pass.

Let’s begin with the Facts:

Prior to 1973, it was illegal for healthcare to be conducted on a “for profit” basis. The Health Maintenance Organization Act was passed by Congress and signed into law by President Nixon on December 29, 1973 to encourage and promote HMOs as a way to reduce the cost of health care on a trial basis. The intention of this act was that entities could eventually begin to use profits to offset costs, thus driving down overall costs. (Or make a buck out of healthcare, however it worked out. Turned out to be the latter.)

All Americans are guaranteed to receive some form of health care should they show up at an Emergency Room at a hospital even if they have no way to pay for it. (This is as a result of the Emergency Medical Treatment and Labor Act passed by Congress in 1986 and signed into law by President Reagan. It’s an unfunded mandate that all hospitals appear to heed; more on this later.) The fact that this legislation was passed leads me to believe that, We the People, believe that everyone is entitled and has a right to basic healthcare.

The annual cost of healthcare in the US is $8608 per capita (that’s as of 2015; current estimate is $10,068 per capita) which is the highest in the world. Despite this, the US does not have the “best health care in the world” as many believe. The following paragraph comes from Wikipedia.

The United States life expectancy of 79.8 years at birth, up from 75.2 years in 1990, ranks it 42nd among 224 nations, and 22nd out of the 35 industrialized OECD countries, down from 20th in 1990.[6][7] Of 17 high-income countries studied by the National Institutes of Health in 2013, the United States had the highest or near-highest prevalence of obesity, car accidents, infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, and homicides. On average, a U.S. male can be expected to live almost four fewer years than those in the top-ranked country, though notably Americans aged 75 live longer than those who reach that age in other developed nations.[8] A 2014 survey of the healthcare systems of 11 developed countries found the US healthcare system to be the most expensive and worst-performing in terms of health access, efficiency, and equity.[9] 

(We must be very proud!)

There is no such thing as “free health care.” Even the indigent, who may get health care they can’t pay for, aren’t getting it for free. It may be free to them but the rest of us are paying for it.

How? Hospitals, bound by the law mentioned above, record the cost of that care on their books as “un-reimbursed expenses” which is above the profit line. That means, it is accounted for as an expense or “cost of doing business” and is simply deducted from their potential profits. In other words, all of those who pay the hospital money (insurance companies, your employer, you in the form of copay or deductibles) pay for it.

That means WE pay for all the health care in the country. Medicare, Medicaid, private insurance, and our employers may send a check to pay parts of our healthcare bill but they get the money to do so from We The People in the form of taxes paid, health insurance premiums, copays, and deductibles. We pay. They 

About 18.5% of all the money in our economy is taken up by the cost of health care. How much is that?

Current In round numbers, it’s $3,400,000,000,000. That’s over three trillion dollars and it continues to go up every year. This is the reason that the Affordable
Current Law
Care Act
and it’s repeal / replacement / adjustment / tweaking are so important to our Congress. And it should be very important to all of us because, in the end, they’re discussing the distribution of almost 20% of our money, each year.

Do you trust them? (And by them, I’m talking about Congress since they’re the ones deciding how this will be done.)

Now, here are my Opinions (along with some additional facts):


I find it ridiculous that healthcare isn’t treated like nearly every other business in this country. What do I mean? Well, we have all kinds of consumer protection laws in place to ensure we don’t get the shaft from just about every type of business but nothing like that exists in healthcare!

When I worked in retail consumer electronics, we were required to have on display
and available for sale in every store, any item that was advertised in our newspaper circular. Failure to do so, could result in a $10,000 fine per location. On any given Sunday, that meant we were on the hook for up to $7 million in fines due to being out of stock and this was enforced by the Federal Trade Commission. (The law came about as the result of bait and switch tactics practiced by some retailers.)
In the world of healthcare, pricing is a kind of smoky unreality that no one really wants to talk about with the patients. (The only place where pricing is upfront is typically in the case of Urgent Care Clinics. These places spell out their prices for visits when you check in. In other words, they act like a retailer. How refreshing!)

Example – an acquaintance of mine was diagnosed with a form of sleep apnea and was prescribed a CPAP device; these blow air in your nose and keep your airway open so you can actually sleep. When they went to the equipment provider, they were unable to tell how much the unit cost and how much the private insurer would cover. This person called the insurance provider and they were unable to explain how much coverage would be provided so that the insured could budget for the purchase. In other words, no one was willing to own up to actual cost for the patient! (In the end, it amounted to over $1200 and this person was able to cover that but most people in this country could not afford that expense; in fact, most Americans couldn’t afford it if it was as little at $400.)

High Costs – because, waste

On a different plane, why is the cost of healthcare itself so high? Particularly when the US clearly isn’t getting much in return? (See rankings above.)

For one thing, there is a great deal of waste involved in our current system. The person with the CPAP machine that I just mentioned received a total of 11 different bills (delivered thru US mail) for the device, despite having gone to only one provider for the unit!

This is an example of waste that occurs on a daily basis in every aspect of health care. In this case there is at least 10 bills too many, all with postage that adds up to around $5 of wasted postage cost. But it’s far more than that. Each of those bills and invoices had to go through various departments/people for processing before being printed and mailed to the insured. A quick Google search tells me that it costs anywhere from $7 to $37 dollars for each invoice produced. If we take the halfway point, that’s $22 per invoice or $220 worth of waste for this one transaction. Bear in mind, that the waste noted here is only on the patient side. If the same number of invoices have to be produced for the private insurers, it doubles. That’s $400 of waste on one transaction (that cost the patient $1200) and we’ve only looked at the billing!

More waste occurs in another way, over-testing. Currently, physicians are reimbursed for procedures / tests that they perform, a methodology known as pay for procedure. The downside to this is that it incents them to perform more tests than may be needed for a given presentation by a patient. Is there justification for this? Maybe. Doctors claim that it helps to keep the cost of malpractice insurance down but I haven’t done any research on that. (I do know that my personal physician sold his practice about 8 years ago and moved into another role in health care because his malpractice insurance had risen to $12,000 per month and he’d never had a claim! That cost was more than he could overcome.)

It’s estimated that a third of health care costs are caused by waste in the system. That seems like a reasonable number to me, especially when you consider that 64% of all healthcare is paid or administered through some form of government program: Medicaid, Medicare, Veteran’s Administration, for example. If that estimate is correct, that is $1 trillion that is being paid for, needlessly, by all of us every year! (That’s 1/12 of the economy.)

Higher Costs – because, profit!

Another cause for the high cost of health care stems from the costs of pharmaceuticals. Manufacturers invest a great deal of money in coming up with new drugs to fix all of the things that ail humankind and I recognize that. But do you know how much they spend on advertising? In 2016, it was $5.2 billion!
WTF with 2 tubs????

Direct to consumer drug advertising began in 1982 but didn’t really get going until 1997 when the law was loosened up and TV advertising began in earnest. It’s gotten really bad the last few years as more and more manufacturers expand their advertising and, coincidentally, their prices. According to a report by CBS News, 20 brand-name, high use, prescription drugs have quadrupled their prices since 2014. In 3 years, that equates to a compound annual increase of 48%! I’m not aware of any current business that is driving it’s pricing in such a way while still remaining in business.

So, “Ask your doctor if continuing to get screwed by high drug prices is right for you!”

Solutions – are there any?

The Affordable Care Act, known colloquially as Obamacare, was enacted in 2010 and signed into law by President Obama. It was designed to reduce the overall cost of healthcare by providing insurance coverage for those who can least afford it and, generally speaking, cost the most.

Remember the law guaranteeing health care for poor people in the ER? That’s where many would go for anything health related. As a result, they’d be going to the most expensive provider for the least expensive need (flu, cold, general maladies) and getting no well care to help keep chronic disease (diabetes, hypertension, high cholesterol) held at bay. Result – increase in health care cost.

The ACA provided millions more people with health insurance, and coincidentally slightly better health care, thus bending the cost curve down. (That’s not really a reduction in expense, it’s a reduction in the amount of increase. It’s better but not dramatically so.)

American Health Care Act
Turn your head and cough!

Now that the GOP is in charge of the House, Senate, and White House, they are bound and determined to fix healthcare once and for all. They intend to do this by repealing and replacing the ACA and replacing it with something better. (Thus, saving us from “the complete failure of Obamacare.” I wish everyone would speak less dramatically about all of this. Obamacare has actually bent the curve down slightly as to the overall cost. I hope whatever the GOP comes up with fails at least that good!)

The House plan calls for reducing the amount of money spent on Medicaid (that’s the one that covers the poorest people in the country) a defunding of Planned Parenthood, along with a loosening of insurance laws that would allow them to sell across state lines (that’s not yet clear on details) and it would leave in place some of the features from the ACA around pre-existing conditions and allowing dependent children coverage until age 26.

This plan would also remove a tax on the wealthiest members of society which was in place to pay for the ACA. (Thank goodness! I was worried about them.)

According to the Congressional Budget Office, this would cause 23 million people currently insured to lose their coverage.

According to the House majority, this would turn loose the power of the open market to reduce prices for insurance thanks to competition and free market forces. It would also allow people to purchase the insurance they want, instead of having it forced up on them. (Except of course poor people who, according to one legislator could just “get a job to pay for it.” Or pay for their living expenses, like food or something.)

The Senate, as of this writing, is still working on their own version of the repeal and replace bill. Things that have been floated out from the caucus that is working on it, don’t sound much different from the House version

My Solution – Hey guys, you’re fixing the wrong things!

I believe that every citizen of the US is entitled to basic healthcare, just like every other developed nation on the planet. I further believe that rich people should be free to purchase even better health care if they wish because, hey, they can!

I don’t believe that the government should be in the administration of health care but I do believe they need to be involved in setting parameters for the business. (Why? It’s 1/6 of our economy. If it’s not regulated we end up with the Great Medical Recession of 2030 or something like it. Don’t think it needs to be? See banking and Great Recession on Google.)

I believe that the only way to do this is by using a system that I call Modified Single Payer. (I fully recognize this is way oversimplified but we have to start somewhere and I'm not against something completely different!)

I propose that insurance companies are designated for every locale in the country. It could be state, region, county, GMA, or something else. Every area has at least 2 companies to insure competition. These are for-profit entities and are required to cover all the citizens in their markets. (Note that non-citizens are not covered by this.)

Providers (that’s the medical people) can sign up with whichever insurer they want or both or none if they prefer. (My back doctor refuses to take insurance and he is doing just fine without it. I don’t want to force any provider on this.)

All of the money (less 30%) that is currently being paid out for healthcare is dumped into a pool to be divided among the payers and it’s their job to pay for the health care being handled by the providers.

The pool of money made up of that 30% is held back for bonuses. As waste is identified and quantified, the bonus money is provided in some form to compensate the group that discovers it, at a maximum of 1/3 of the bonus pool. This could be providers, insurers, even patients! If no waste is discovered, no bonus is paid. 

All of the money left over at the end of a period (2/3 or 20% of the total spent) is refunded back to the citizens who paid it into the fund. (If someone didn’t pay any in, they don’t get any back.)

I submit that this would improve out healthcare AND our health while improving our economy ($680 billion back in the hands of Americans that isn’t going to health care? New TVs for everybody!!!!). And we might even have a health system that rivals other countries.

What a concept!

OMS vai declarar que ser transgênero não é doença: é natural
O próximo alvo é retirar os casos de pessoas transgênero da lista de doenças mentais

Homicídio por arma de fogo é registrado em Poço Verde-SE
Um homicídio aconteceu nesta noite de sexta-feira (12) na cidade de Poço Verde. Os primeiros levantamentos dão conta que o homicídio por arma de fogo aconteceu na localidade conhecida como Rua Santo Antônio e a vítima era popularmente conhecido pelo apelido de “Everaldinho”.

Detento morre em briga com colega de cela na ala gay do Presídio de Vespasiano
De acordo com a Seds, colega de cela da vítima, que tinha 22 anos, assumiu o crime. Caso será investigado pela Polícia Civil
Um preso de 22 anos morreu após se envolver em uma briga com um colega de cela na ala para homossexuais do Presídio de Vespasiano, na Região Metropolitana de Belo Horizonte. A confusão aconteceu na noite de segunda-feira.

Travesti é morto e jogado de cima da passarela
Com requintes de crueldade, 16 homossexuais foram assassinados no Pará, somente esse ano. O índice corresponde à média de 2 homossexuais mortos por mês, vítimas da violência e da intolerância. Os dados são da Delegacia de Crimes Discriminatórios e acompanhados pela Gerência de Proteção pela Livre Orientação Sexual da Secretaria de Estado de Justiça e Direitos Humanos (Sejudh). O caso mais recente foi registrado na madrugada de ontem (19), no município de Castanhal, na região nordeste do Estado. O travesti, identificado pelo prenome social de “Brenda”, idade não divulgada, foi encontrado morto às 4h30, com vários golpes de faca pelo corpo, numa passarela, na rodovia BR-316, no centro da cidade. O número de facadas não foi divulgado por peritos do Instituto Médico Legal.
Travesti é morta e jogada de cima da passarela

Médicos travestis e transexuais devem poder usar nome social em SP
Cremesp quer aprovar resolução até setembro; OAB já adotou medida.
Para estudante transexual de medicina da USP, medida é 'retalho de direito'.

'Era cheia de sonhos', diz mãe de travesti assassinada em cidade de MT
Tiffany Rodrigues tinha 24 anos de idade e foi assassinada em Alta Floresta.
Mãe da vítima diz que a filha 'não tinha inimigos' e pede por Justiça.

Na luta contra o preconceito, travesti e prostituta se candidata a vereadora
Conhecida por seu ativismo na causa feminista, LGBT e das profissionais do sexo, Indianara Siqueira lança candidatura pelo PSOL do Rio de Janeiro

Suspeito de envolvimento nas mortes de homem e travesti se entrega
Crimes aconteceram em Maringá, na madrugada do dia 8 de agosto.
O suspeito de matar as duas pessoas foi preso três dias após o crime.

Colectivos califican como "delito de odio" y agresión "brutal" el ataque sufrido por una transexual en Málaga
Andalucía Diversidad, la Asociación de Transexuales de Andalucia-Sylvia River o la Federación Arco Iris han manifestado su repulsa por la agresión en Málaga

Parliament told to introduce gender-neutral toilets to ‘plan ahead’ for transgender MPs
A report has urged the UK Parliament to introduce gender-neutral toilets – though there are currently no transgender MPs.

Woman feared walking down Brighton’s streets after trans abuse
Sian shares her story after the courts give her abuser a tougher sentence because he was motivated by transphobia

Government slammed for ‘lukewarm’ commitment to transgender reforms
Labour and the Scottish National Party have questioned the government’s response to a report calling for urgent changes on trans issues.

Parish newsletter refuses to print transgender councillor's article about transition as it 'could upset villagers'
A transgender councillor has criticised her "old-fashioned" parish newsletter for refusing to print an article about her transition - because it could upset villagers.

Jack Monroe: ‘I want to be treated as a person, not as a woman or a man’
She was the poster girl for austerity Britain, a famous food writer and poverty campaigner, and then she suffered a breakdown. Jack Monroe talks politics, party frocks and being transgender

Jeremy Clarkson mocks trans-friendly toilets: ‘You might as well install urinals for Klingons’
Jeremy Clarkson has hit out at a report that calls for gender-neutral toilets in Parliament, claiming “you might as well install urinals suitable for Klingons”.

Leeds Beckett University honour for transgender Capital Radio star Stephanie Hirst
Radio star and transgender icon Stephanie Hirst has received an Honorary Doctorate from Leeds Beckett University for her contribution to public life.

Britain will deal with Brexit by trading with North Carolina
UK will boost trade with office in anti-trans state
UK government to open trade hub in North Carolina despite controversy over anti-LGBT law
Owen Smith slams UK government over ‘offensive’ North Carolina trading hub

New policy for transgender inmates launched
Four inmates have already switched wards, to reflect the gender listed on their official documents

Genderqueer: A Former Soviet Soldier Looks For Her True Self (Video)
Growing up as the son of a Soviet officer, Tapir knew he was not the man he was expected to be. Through his own military service, marriage to a woman, and subsequent sex change, this devout Christian's confusion over gender identity continued. Recently, Tapir came to the realization that she is neither male nor female, but somewhere in the middle. She discovered that the quest for happiness is far more important than choosing between gender stereotypes. RFE/RL's Russian Service series, "Signs of Life," has Tapir's story in her own words. This is an excerpt from the documentary.

Hundreds of LGBT activists Defy Police in Protesting for Justice for #HandeKader
The LGBT community defied the Turkish government’s ban on rallies amassing today in support of murdered transgender woman Hande Kader. Transgender activists and allies enraged over the burning death of Hande Kader jumped police barricades to rally in solidarity for the slain transgender woman. This is an incredible act of bravery since following the attempted coup earlier this year the country has suspended its human rights treaties, declared martial law and arrested 102 journalists.
LGBT protest in Turkey sees hundreds of activists stage rally over brutal killing of transgender woman
Hande Kader: Outcry in Turkey over transgender woman's murder
Trans Woman Brutally Murdered in Turkey
Murder of transgender woman shines dark light on rights issues in Turkey
‘Other’ victims of Turkey: Hande, Aslı and R.D.

Transgender shot at by unidentified assailant in Ghaziabad
A transgender, also a resident of Vijay Nagar in Ghaziabad, was reportedly shot at by unidentified people late on Saturday night. The incident was reported from Prem Nagar area of Ghaziabad when the victim -- Annu Sharma was returning to her place after paying a visit to a friend in the area.

[South Korea]
Transgender Women Are Heading to South Korea for Vocal Surgery
A clinic in Seoul has become a destination for a noninvasive feminization procedure.

[Hong Kong]
Transgender prisoners in Hong Kong suffer sexual assault, denial of hormones
All male-to-female transgender inmates are regarded as mentally ill and detained in male wards in a maximum-security psychiatric centre; an upcoming judicial review could bring a change in policy

Pattaya hotel guests unaware of dead body under bed
Two guests spent a night in a Pattaya hotel unaware that there was a dead body under their bed, according to local reports.
The body of the slain transgender woman was only discovered after the guests had checked out, when a maid noticed blood near the bed.

This trans woman was refused a Brazilian wax because she hasn’t had gender reassignment surgery
A transgender woman has spoken of being refused a Brazilian wax because she has not undergone gender reassignment surgery.
Karen Parker said she booked the wax at Brazilica in Brunswick, Australia, as a birthday present to herself in October 2015.
But on arriving at the venue, and when the staff member realised Parker had not undergone gender reassignment surgery, she refused to wax her.

Transgender children 'left with few options in Northern Territory'
Around the country there has been a huge spike in children seeking medical treatment to change their gender, but for transgendered kids in the Northern Territory the options are still bleak.

Census will count people who aren't just male or female
The Australian Census is the latest admin bureau to accept that some folks don’t fit the gender binary.
Australian Census embraces gender diversity

Transgender rights case fights to axe gender from birth certificates
As B.C. adds gender identity and expression to its Human Rights Code ahead of Pride, an LGBTQ rights case fights forcing ‘male’ or ‘female’ on newborns.
BC group launches ‘M’ and ‘F’ discrimination complaint

Transgender human rights bill passes, with some Liberal dissent
A new law to protect transgender rights in B.C.’s Human Rights Code passed into law Monday, despite opposition from at least one of the governing party’s own MLAs.
BC passes trans rights in one sitting
Trans Alliance Society chair applauds transgender-inclusive changes to B.C. Human Rights Code
'It's a good day for all British Columbians'

Tracey Africa Norman Is Back As the Face of Clairol
This December, when the Cut published a cover story about Tracey Africa Norman, the first black transgender woman to work, undetected, as a successful fashion and beauty model, we hoped her story would touch people and bring attention to her remarkable career. We could not have predicted that it would result in a phone call from Clairol, whose Born Beautiful hair-color boxes Tracey’s face had graced in supermarkets nationwide 30 years ago, asking her to come back to work.

Jenner makes it official, I am Cait Canceled after Two Seasons
After a long pregnant reality show style pause, Caitlyn Jenner tweeted announcing the end of I am Cait today. Quite a few media outlets jumped the gun announcing the demise of I am Cait weeks ago, but Planetrans out of respect waited for Jenner to say it. The highly cis acclaimed and cited show tried to go where trans people seldom venture. Caitlyn failed twice. One, she distanced herself from the vast majority of politically aware trans people with her unabashed right wing views. I cringed many times wondering if cis people thought she was speaking for me.

Miss Major Is A Trans Elder And Stonewall Icon.. And She’s Changing The World
“People have to get involved with this and not just one particular group — it’s all of us or none of us.”

TSA stops transgender delegate from SF for ‘groin anomaly’ on way to DNC
For Mia “Tu Mutch” Satya, even the stature of national politics was not enough to shield her from everyday gender discrimination.

Here’s Proof That Policing Trans People In Bathrooms Isn’t Actually About Women’s Privacy
As state lawmakers across country have pursued laws to police trans women’s bathroom use, allegedly in the name of protecting cisgender women from sexual assault or being peeked at in stalls, other efforts to compromise women’s privacy have gone unchecked.

Sigourney Weaver's newest film makes horror out of trans surgery
The Toronto International Film Festival recently announced that it will show Walter Hill’s (re)ASSIGNMENT, a feature-length action-thriller about a hitman who becomes a vengeful hitwoman after an evil doctor gives her a non-consensual gender reassignment surgery. The film (which was originally entitled, Tomboy: A Revenger’s Tale) stars bisexual actress Michelle Rodriguez as the hitwoman (aka “Tomboy”) and Sigourney Weaver as the doctor and possibly continues an unfortunately long history of transphobic film tropes.

Backstage with “Strut” America’s 1st Transgender Model Reality Show
“They want a girl that’s 6’2, 35-25-35 they didn’t ask if I had a penis or not. A decade ago we were hiding on the runway, but now, it’s a new age!”

D.C. bathroom assault ruled hate crime
Marks the seventh official biased hate crime of its kind in the District this year

Security Guard Charged With Hate Crime For Assaulting A Transgender Woman In May
When Francine Jones assaulted a transgender woman at a Giant grocery store in May, police charged her with simple assault. After further investigation into the incident, the U.S. Attorney's Office for D.C. has also charged Jones with bias-related assault. Authorities added the second charge on July 11, according to spokesperson William Miller.

Transgender inmate challenging Florida prison laws found dead in cell
Convicted killer Justin Lee Naber wrote in a handwritten lawsuit that it was “cruel and unusual punishment” to be forced to use a male name that no longer fit her gender. She wanted the name on her birth certificate to read “Stacy Lorraine Naber.”

Transgender inmate sues corrections agency
A transgender inmate is suing Florida Department of Corrections officials for refusing to allow her to continue hormone treatments and for forcing her to dress as a man.
Reiyn Keohane, 22, has lived as a female since she was 14, according to a federal lawsuit filed Monday on her behalf by the American Civil Liberties Union of Florida.

The state of Georgia just said it is not illegal to take photos up women’s skirts
The state of Georgia just affirmed that it is totally legal for someone to take a photo up a person’s skirt in public without her consent.

Transgender prison nurse accuses state of discrimination
A transgender male who is a longtime Iowa Department of Corrections nurse has filed a complaint against the state and his insurance provider alleging he was discriminated against because of his gender identity.

EEOC Sues Rent-A-Center for Sex Discrimination Against Transgender Employee
Assistant Manager of Rantoul Store Was Fired Because of Her Gender Identity, Federal Agency Charges

Dozens rally in response to new mandate regarding transgender students
A rally occurred in Alton,Ill., to discuss both sides of the transgender bathroom mandate
Sides clash in Alton at rally against trans restroom law

DOJ criticizes Baltimore police treatment of trans people
The Department of Justice released a scathing 164-page report on Aug. 10, which was the product of its investigation of the Baltimore Police Department. The investigation was commissioned by the City of Baltimore and BPD last year following the unrest and rioting in the city after Baltimore resident Freddie Gray died in police custody.

Family confirms St. Martin homicide victim was a transgender woman
Saturday night's stabbing death at a St. Martin hotel is being investigated as a possible hate crime because the victim was a transgender woman.
Update: St. Martin homicide victim was transgender woman
Navy sailor charged with capital murder of transgender woman
New Orleans man arrested in Mississippi stabbing death of transgender woman

Transgender man from Lucedale admits having sex with transgender minor
Transgender man had allegedly been in a dating relationship with victim
Suspect admitted committing crimes against the minor at different times in 2012 and 2013
Sentencing is deferred until September

NBA moves 2017 All-Star Game out of Charlotte over HB2; 2019 return possible
After months of lobbying to change House Bill 2, league chooses to move the February event
The league has said it views HB2 as discriminatory against the LGBT community
If circumstances change, Charlotte might host the All-Star Weekend in 2019
John Swofford: ACC will revisit HB2, championship game location in fall
2017 PGA Championship will stay in Charlotte amid HB2 controversy
Lambda Legal Commends NBA Decision to Move All-Star Game From North Carolina
North Carolina governor Pat McCrory fires back at NBA decision over All-Star Game
North Carolina Governor Attacks NBA For Pulling 2017 All-Star Game
Franklin Graham blasts NBA for moving All-Star Game from North Carolina
Blame Game Follows NBA's Removal of Charlotte All-Star Game
‘SHAME ON THEM:’ owner of Hornets blasts NBA, Charlotte, trans people
Raleigh entrepreneur blasts HB2 at DNC

Trans Woman Receives Settlement in Lawsuit Against Hospital
Faye Seidler, a transgender woman who has brought a lawsuit against her former employer, Sanford Medical Centre in Fargo, ND, has reached a settlement for discrimination in the workplace.

Macy’s fires Catholic employee for questioning transgender bathroom policy
Macy’s department store has fired a Catholic employee because he questioned their transgender bathroom policy, even though he says he told his employer he would enforce the policy.

Transgender woman attacked with hammer in possible hate crime
A transgender woman was struck in the head while walking down a sidewalk in Queens.

Trans ex-employee sues Abercrombie & Fitch over ‘look policy’
A transgender former employee is suing Abercrombie & Fitch for $35 million because, he claims, he was humiliated and fired for his refusal to wear women’s clothing on the job.

Once-convicted transgender killer blames media, judge for 'poisoning' case
Dwight DeLee hasn't been shy about talking back to a judge in court.

Transgender ex-special forces soldier reveals inner battle to accept true identity after using combat 'to become a man'
Alana McLaughlin looks like any other young woman but she was previously a stacked figure of rippling muscle in a bid to become more manly

Nashville man attacks transgender prostitute
A Nashville 47-year-old was jailed for Aggravated Assault after he picked up a prostitute and became angry after finding the prostitute was transgender.

Texas School Promises To Out Trans Kids To Their Parents
Fort Worth Independent School District, the sixth largest school district in Texas, has issued a new version of its guidance to protect transgender students from discrimination. Instead of eight pages outlining how the district will respect and accommodate students’ gender identity, the guidance is now just a two-page document about working with parents to create an individual education plan. If parents aren’t involved and supportive of their student’s identity, then the student will seemingly not be accommodated.

Marius Mason makes history as first Transman to get HRT while a Federal Prisoner
Marius Mason website says he’s is the first FTM federal prisoner to begin hormones treatment which could lead to SRS, and it’s happening right here, in the heart of Texas. That ought to make vehemently transphobic Gov., Lt. gov., and adjutant-general dance with glee. Then again, perhaps not. But why should any transgender person be denied basic healthcare? This is a right of all prisoners after all. But it was a long battle for Mason to reach this point. The DOJ Rules meant to protect transgender people instated in 2012 have been largely ignored.

Transsexual beauty queen from Puerto Vallarta brutally murdered
Paulett Gonzalez, who won the title Gay Beauty Queen in 2015 in the state of Nayarit, was found burned in the town of Celaya, in the state of Guanajuato, official sources confirmed to EFE.
Trans beauty queen found murdered in Mexico

A surprising move on LGBT rights from a ‘macho’ South American president
Bolivia has a new gender identity law that might put it in Latin America’s vanguard on LGBT rights — but the story behind the measure reveals how far the Andean nation still has to go before ending homophobia. That’s according to Carlos Parra, aka Paris Galán, the country’s best known drag queen and a prominent gay rights campaigner.

“El baño mixto es una pequeña solución para la discriminación”: rector de la U. Externado
Desde el lunes todos los estudiantes de esta universidad, sin importar su género, compartirán estos espacios. La medida obedece a un asunto de equidad.
El debate por los baños mixtos

Fiscalía exige al TSJ adecuar la identidad legal de los transexuales
Luisa Ortega solicitó a la Sala Constitucional remover todos los obstáculos legales que se opongan a los preceptos constitucionales y causen discriminación

          The Family Meal: Home Cooking with Ferran Adria        
Ferran Adrià
Ferran Adrià is a chef known more for molecular gastronomy than home cooking, but these meals for the kitchen staff and simple and delicious, using very basic health ingredients. Rich series of photographs illustrate each step in the recipe.
Reading Category: 

          New York Magazine has a problem with pseudoscience*        
Not just New York Magazine, of course. The issues here are almost industry-wide (Cracked and the Gawker remnants have fairly clean hands), but NYM might be a bit worse than average and is, at the very least, a good place to start given its association with the conspicuous consumption lifestyle porn that drives so much bad health science.

There is a troubling symbiotic relationship between journalists and people like Gwyneth Paltrow who can be subjects, sources, advertisers, even potential colleagues and employers.

Here's what came up next to one of the stories below.

The problem is compounded by an ethical code focused on covering your ass rather than getting at the truth. NYM reporters are particularly adept at working that system, including just enough snark and caveats to give themselves just sufficient distance. Take a look at this recent example:

I Took the Best Nap of My Life on a $9,000 Crystal Bed by Allie Jones

I hate to do this, but I have to recommend a moderately expensive wellness practice that has no scientific basis or proven medical benefits whatsoever. Last week, I tried Crystal Bed Therapy at the recently opened alternative medicine studio Modrn Sanctuary, and I was changed. I don’t think it did what it was supposed to do (realign my energy field?) but it did make me feel intensely relaxed and also sort of high.

To belabor the obvious, “no scientific basis” doesn't mean much if it's followed by a testimonial, but it does immunize Jones to a degree from the criticism that she's promoting pseudoscience. That's clearly what she is doing, but if challenged, she has plenty of qualifiers to point to.

If you do the promoting in passing, you don't even need the caveats. Check out the end of
Gwyneth Paltrow and Serena Williams are Getting Into the Food Business Together

Subscribers of the DIY-smoothie company can choose from among three plans that ship frozen “superfoods” to their door on a weekly or monthly basis. Plans run between $48 to accommodate the ingredients for six smoothies and $168 for a month’s supply. It is unknown if the smoothies are delicious, but they will undoubtedly be healthy.

“Undoubtedly”?!? First off, there are no “superfoods.” Second, the suggestion that you can count on a Paltrow product to be healthy (or safe, for that matter) is somewhere between funny and sad.

Of course, those are just quick little fillers. Is the standard higher for a major feature? Yes and no...

The Wellness Epidemic by Amy Larocca

Wellness is a very broad idea, which is no small part of its marketing appeal. On the most basic level, it’s about making a conscious effort to attain health in both body and mind, to strive for unity and balance. And it’s not a new idea either. Homeopathy, which uses natural substances to promote the body’s ability to self-heal, was popularized in Germany in the late-18th century, and 50 years later, the YMCA set its mission as caring for the body, mind, and spirit. Dan Rather did a 60 Minutes segment on wellness in 1979, but it was approached more as a fringe phenomenon. “Wellness,” he said, “that’s not a word you hear every day.”

Putting aside the annoyance at seeing the Y (an organization based on giving young men an alternative to taverns and brothels) in bad company, you can't simply say this about homeopathy. This is not a practice that “uses natural substances to promote the body’s ability to self-heal”; it is a practice that does nothing. It is the poster child for medical pseudoscience.

Or later on...
It can be easy to be cynical about wellness, about the $66 jade eggs that Gwyneth Paltrow suggests inserting in your “yoni.” There’s something grotesque about this industry’s emerging at the moment when the most basic health care is still being denied to so many in America and is at risk of being snatched away from millions more. But what’s perhaps most striking about wellness’s ascendancy is that it’s happening because, in our increasingly bifurcated world, even those who do have access to pretty good (and sometimes quite excellent, if quite expensive) traditional health care are left feeling, nonetheless, incredibly unwell.

Cynical is not nearly a strong enough response.  Writing for Gizmodo, Kristen V. Brown explains:

“A lot of things here are concerning,”said Jen Gunter, a San Francisco OB/GYN. “For one, this is a porous rock you’re putting in there, not medical-grade silicon, and who knows what bacteria can lodge in those nooks and crannies. Then there’s also this magical belief that putting something inside you can do something to your aura or chi.”
Gunter, whose practice specializes in pelvic floor disorders and infectious disease, said it’s not just that Paltrow is peddling pseudoscientific eastern mysticism—it’s actually bad medical advice.

If you really wanted to strengthen your vagina’s pelvic floor, for example, Gunter said that sleeping with a weight down there or walking around with it inside of you won’t do the trick. The key, she said, is exercises to tighten and relax the muscles. Keeping an egg up there, she said, could actually do the reverse and damage those muscles.

21st Century journalism has a problem with pseudoscience, It's time for an intervention.

* And real science, too.
          Deciding on Daycare: A Health & Safety Checklist        

Choosing a daycare or preschool for your child depends on a lot of factors, but some basic health and safety questions should apply to any care provider, regardless of size.

The post Deciding on Daycare: A Health & Safety Checklist appeared first on Healthy Balance.

          Celebrities take to Twitter, Instagram to celebrate historic marriage equality ruling        

Today the United States Supreme Court made a historic ruling and determined that the Constitution guarantees every American the right to marry the person they love. “Today, love prevailed and our nation became a more perfect union by affirming that all people are indeed created equal and justice belongs to everyone,” said Sarah Kate Ellis, President and CEO of GLAAD.  "With this decision, loving and committed same-sex couples can finally rest knowing their families are protected and their dignity is no longer up for public debate. But as we celebrate this watershed victory for fairness, we are reminded that marriage equality is a benchmark, not a finish line, and our work to bridge the gap to full acceptance for LGBT people continues.”

See how celebrities celebrated marriage equality on Twitter and Instagram.

What a beautiful day! It's about time. #LoveIsLove #LoveWins #WeAreAllEqual

A photo posted by Shay Mitchell (@shaym) on

ALL love will be recognized and celebrated.

A photo posted by Troian Bellisario (@sleepinthegardn) on

Today is a beautiful day! #lovewins

A photo posted by craccola (@craccola) on

A photo posted by @chrissyteigen on

#iwokeuplikethis #amazingamerica #lgbt #love #freedom IM PROUD TO BE AN AMERICAN!!!

A photo posted by Raven-Symone` (@ravensymone) on

June 26, 2015

          Colombian Prison Strikes Continue-Inhumane Conditions “Made in the USA”        
by James Jordan
Strikes involving thousands of prisoners at 21 institutions continue in Colombia against the humanitarian crisis in the jails. Overcrowding is rampant and in many prisons the availability of potable water and clean, unspoiled food is severely restricted. There is little adequate health care, especially for the seriously ill. For instance, José Lamprea is a prisoner whose four year sentence is in danger of turning into a death penalty. Confined to a wheel chair by what may be bone cancer, he has still not received medical treatement that was court ordered in November, 2011.

Torture is so commonplace in the jails that a 2008 study by Colombia’s Committee in Solidarity with the Political Prisoners showed that when asked if the inmates had been tortured at least once during their jail time, 54% answered they had and 46% did not answer the question at all. Eighty-six percent said that they had experienced psychological torture, including threats to relatives and simulated executions.

Conditions in Colombian prisons should be of special concern for residents and citizens of the United States. In 2000, the US Ambassador signed an agreement with the Colombian Minister of the Interior named the Program for the Improvement of the Colombian Prison System (PICPS). Under the PICPS, the US would help build a series of new prisons to create a “New Penitentiary Culture”. This effort has been funded and advised via USAID (United States Agency for International Development) and the US Bureau of Prisons.

One reason given for this program was to alleviate overcrowding. However, rates of arrests went up far more quickly than new jails and the number of political arrests that were later thrown out of court for lack of evidence rose by 300% (with most of the accused spending two to three years in jail before release). This does not include political prisoners who have been convicted for their activities. The estimated number of political prisoners has grown from 7,200 to over 10,000 since 2008.
New jail construction has been less about relieving overcrowding than preparing for a much larger prison population as a result of social and economic disruption and punishing political dissent. With passage of the US-Colombia Free Trade Agreement many observers fear that poverty rates will worsen and crimes of desperation and prison populations will increase. Unfortunately, US and Colombian authorities see the “New Penitentiary Culture” as a model and are seeking to replicate it in Central America (where in Honduras the US has announced a new “Model Penitentiary” program) and Mexico (where the US is funding construction of 16 new federal prisons).

According to Tulio Murillo Avila, who is a national spokesperson for the Movimiento Nacional Carcelario (National Movement in the Jail),

Jail over-population…is not a new thing, being found today at a national level of 47%, due to the policies of punishment…in the new centers of incarcerations constructed under the influence of the US Bureau of Prisons. In some jails the overcrowding has reached 400%.
Bellavista Jail in Medellín

In a video-recorded interview with the Colombian media outlet RPASUR (Western Colombia Alternative Press Network- ), one prisoner representative reported that, “The gravest are the problems with hygiene in the jails and overcrowding. Colombia has a capacity for 78,000 prisoners. We find in Colombia more than 130,000 prisoners.” Almost one-third of the incarcerated are unconvicted persons awaiting trial who are mixed in with the general population and are often subjected to processes that take years before a verdict is rendered.

The first prison constructed with US funding and advice was La Tramacúa, located in the city of Valledupar. Although a “modern” facility built on the basis of US designs, it has become infamous for its terrible conditions. La Tramacúa has been found on at least three occasions (by agencies from the United Nations and the Department of César, as well as by an internatinoal NGO) to be serving food tainted with fecal matter. Sanitary facilities are rarely working and inmates are forced to relieve themselves in buckets and plastic bags which are “disposed of” by being thrown over prison walls.
In 2010, Raquel Mogollón, a member of the Alliance for Global Justice “Colombia Watch” working group, had the chance to visit La Tramacúa with a delegation of Colombian legislators and international human rights defenders. According to Mogollón,

…Inmates say they’re getting access to water about ten minutes a day. However, in the cells there is water…disgusting, dirty water on the floors. [Editor's Note: Past visitors at La Tramacúa have reported that sewage lines often overflow and open sewage runs by kitchen facilities.]
The prison was absolutely, suffocatingly hot with just a few water pipes. What was really bad–I got a look at the water bottles. They were all full of mold. They aren’t able to clean their water jugs. There’s just not enough water available. At one point, you could hear the water coming through the pipes. All the men started running….

The whole place smelled. They said it was cleaned up for us. Mostly, it smelled like urine. They said the bags of feces had been gotten rid of….

The kitchen area was totally dark. They said they’d cleaned that up, too, but it wasn’t that clean. There were three fans and ten giant cauldrons where they were cooking some soup or stew. In the other room where they prepared the food, it was full of flies. There was grease all over the floor. It didn’t smell very good. I saw vegetables and fruit that were spoiled in the preparation area, with flies all around them.

Prisoner collecting daily water at La Tramacúa

Since the beginning of the PICPS, there has been a series of prisoner strikes against such conditions. More often than not they have been violently repressed. Beginning on August 2, 2012, nonviolent resistance began that has included as many as 11,000 prisoners in 21 institutions and is still continuing. Prisoners have used a number of different tactics including hunger strikes, the refusal to participate in prison counts or work programs or to wear prison uniforms, and self-suspension from prison balconies and railings in make-shift hammocks and harnesses. The number one demand of the prisoners is that the Colombian government establish a National Board of Consultation that includes prisoner spokespersons in order to resolve the crisis in the jails.
The prisoners have formulated an additional five basic demands:
  1. Declare a Social and Humanitarian Emergency in Colombian jails;
  2. Regionalize prisoners in institutions near their families;
  3. Reduce all sentences by 20% and increase the use of alternative sentences such as home detention;
  4. Resolve problems of health, sanitation and overcrowding;
  5. End the extradition of prisoners to foreign countries (which is interfering with Colombia’s internal peace process and in ongoing investigations of links between paramilitary death squads and Colombian politicians).
The response of the Colombian Bureau of Prisons (INPEC) has so far been yet more repression and neglect. On August 10th, according to the legal collective and political prisoner solidarity organization Lazos de Dignidad (Links of Dignity), which, along with Traspasa los Muros (Beyond the Walls), which they co-founded, has been one of the primary outside organizations supporting the strikers,
…prisoners of the La Modelo jail in Arauca informed us that, in the morning hours, INPEC guards physically attacked four prisoners in Patio One…in reprisal for their participation in the National Days of Protest…..The attacked prisoners were placed in solitary confinement instead of being…attended by medical personnel….

The 12th of August of 2012, in the afternoon hours, spokespersons for the 34 hunger strikers at the Penitentiary Complex of Picaleña (Ibagué, Tolima), informed us that the state of the strikers has deteriorated, [and they are] suffering severe dizziness, nausea, stomach sickness, cramps, fainting and decreased mobility, without INPEC offering adequate medical attention….
Of particular concern at La Picaleña has been the condition of prisoner spokesperson Alba Libia Esquivel whose health has been especially affected. Esquivel has been on a hunger strike since August 8th.

Lazos also reported that on August 23,

…in the afternoon hours, the Immediate Reaction Group (GRI) of INPEC entered the High Security Penitentiary in Combita, Boyacá, in a violent manner, proceding to launch tear gas and to beat the strikers, leaving various wounds….Those wounded have been taken in stretchers from their units, their whereabouts unknown.”

On August 27, according to a report from Lazos,
…in the jail of Valledupar, “La Tramacúa”…inmates of Tower Four climbed the structure as a form of protest of the present crisis in the jails. In the morning hours…Sgt. Lucio entered with a group of guards launching tear gas and repressing the protest and attacking the inmates with clubs. The prisoner Wilson Jiménez Mora, who was found suspended from the structure, was thrown from the third floor resulting in a fractured leg.

Isolation from families is the single most oft-cited prisoner complaint. Most prisoners come from impoverished backgrounds and families cannot afford trips to visit faraway prisons. Also, given Colombia’s difficult terrain, and the lack of infrastructure development, a trip of 200 miles can routinely take 12-15 hours in the mountainous regions.

Mogollón tells of a particularly poignant encounter she had while visiting inside La Tramacúa:
The worst thing, the worst kind of torture, wasn’t any kind of violence or anything like that. It seems little, but so many people came up to me and told me about not being able to see their families, being completely shut off. When we walked between the Towers, the prisoners were all bunched up around the gates. People would be calling to me, ‘Doctora! Doctora! Madre! Madre!’ They would want me to write their names down.

One man said, ‘I’ve been here eight years! I can’t see my daughter!’

Another said, ‘I’ve been here twelve years and I haven’t seen my mother the whole time!’
It was one plea after another like that, people who hadn’t seen their families for years. When I asked why, one man responded, ‘We’re poor. Our families can’t afford to make the long trips. And when we think of them coming in here, how it smells like feces, it’s so humiliating, so disgusting. It is so hard to think of them seeing us like this.

Mogollón again talked about the pleas she would hear as she walked through the institution’s halls.

We would have to walk through these passageways that crisscrossed among the different units. All the prisoners would be crammed up at the gates and windows, calling to me, “Doctora! Doctora!’ or ‘Madre! Madre!’. I would put my hand up just to acknowledge them. They would give me papers with their names on them. One inmate called to me, ‘Please, please, Madre! I’ve been here six years and I have two hernias. I can’t get treatment, I can’t get medicine!’

Another told me, ‘Look, you’ve got to listen! There is no re-socialization here! There’s no such thing!’

Finally, at one point I stopped in one of the passageways and spoke back to them. I said, ‘Look, I wish I could help each one of you, but I can’t! I can’t because this place is modeled on a US system. This model is based on punishment and the people who designed this system don’t care about re-socialization. They don’t care what happens to you! All I can do is to go back and do what I can to change this whole system and draw attention to what you are suffering.
All of a sudden, they started clapping, yelling, ‘Go on!’ and ‘You speak the truth!’

And that is what we must do here in the US: we must go and speak the truth about this situation our government has helped create. We must intervene on behalf of Colombia’s prisoners—not only the more than 10,000 political prisoners, but on behalf of all those whose lives have been broken by the US/Corporate Empire and the neoliberal economic and political system it tries to impose throughout the world.

Here are some things that you can do.
      1. Cut and paste the follwing sample in Spanish or write your own message and email it to the following Colombian, United Nations and US State Department Officials, and to AfGJ, at:,,,,,,,,,,,,,,,

Todo el mundo esta observando lo que pasa en los penitenciarios en Colombia. Sabemos del hacinamiento; que las cárceles no están proviendo a sus internos las necesidades básicas como comida y agua limpia y servicio desalud; que violencia en contra de las presas y los presos es epidémico; que los servicios de resocialización son limitados y en vez se favorecen las políticas de castigo y negligencia. Yo apoyo a los y las huelgistas de las cárceles colombianas que exigen condiciones mejores y especialmente apoyo la declaración de Estado de Emergencia Carcelaria y el establecimiento de una Mesa Nacional de Concertación que incluye portavoces para las presas y los presos con la meta de resolver esta situación.


The whole world is watching what is taking place in Colombian prisons. We know that Colombian prisons are overcrowded; that many prisons are not providing their inmates with basic necessities such as clean food and water and basic health care; that violence against prisoners is epidemic; that rehabilitation services are severely limited in favor of policies of punishment and neglect. I support Colombia’s striking prisoners in demanding better conditions and, especially, the declaration of a State of Emergency in the Colombian penal system and the establishment of a National Board of Consultation, including spokespersons for the prisoners, to remedy this situation.
  1. Call or fax the Colombian Embassy in Washington, DC, using the above sample or your own words. They can be reached at 202-387-8388 or you can send them a fax at 202-232-8643.
  2. There’s a very good chance that your Representative and Senators in the US Congress do not even know about the US-sponsored PICPS and the “New Penitentiary Culture”. We encourage you to set up a visit with your elected representatives to educate them about this issue and to demand that they use their influence to call on the Colombian government to take immediate action to improve conditions in the prisons and to call for a Congressional investigation of the PICPS and the conditions it has lead to in prisons such as La Tramacúa. We must also ask them to intervene to stop this model from being further imported into Central America and Mexico. If you would be willing to organize such a visit, please send an email to to receive background material for your visit.

          Universal Health Coverage (UHC) needs to be truly equitable and universal        

On 6 December the Global Conference on Universal Health Coverage for Inclusive and Sustainable Growth convened in Tokyo, Japan. The event was co-organized by the Government of Japan and the World Bank Group under the Japan-World Bank Group Partnership Program for UHC.

World Bank Group’s commitment to UHC was laid out by its President, Jim Yong Kim: “At the World Bank Group, achieving universal health coverage and equity in health are central to reaching the global goals to end extreme poverty by 2030 and boost shared prosperity” and “Helping countries advance universal health coverage is a strategic priority across the World Bank Group”.

The World Bank and World Health Organization released a joint framework for monitoring progress towards universal health coverage, with one target for financial protection and one for service delivery.

Oxfam response

Oxfam applauds the World Bank’s continuing leadership on Universal Health Coverage and their ongoing collaboration with the World Health Organization, which increasingly highlights inequity as the crux of the problem.

We welcome the clear commitment laid out in two new objectives – to halve the number of people impoverished by health care payments by 2020 and eliminate the problem altogether by 2030, and to double the number of poor people with access to health care services by 2020 - from 40% to 80%.Setting targets and deadlines at last gives us progressive goals the world can hold the World Bank Group accountable to. We urge the World Bank to incorporate these targets into its results framework for IDA 17.

Oxfam welcomes Jim Kim’s public commitment to reduce out-of-pocket payments. User fees are the most inequitable method for financing health care services. Worldwide every year 100 million are pushed into poverty by direct health-care costs – the equivalent of a quarter of a million people every day. But we would like to see a much more explicit and detailed plan from the World Bank Group as to how it will help countries to remove fees for health care. The World Bank can and should support countries to develop more efficient and equitable ways of raising revenue for health. User fees should not be replaced by health insurance schemes that rely on collecting premiums from people who are too poor to pay.

There is strong evidence to show that the countries making most progress towards UHC have prioritized spending on health from general taxation – either on its own or pooled with formal sector payroll taxes and international aid. Read our report on this issue.

We support the new targets for improving access to health care services for the poor, but we urge the World Bank to be clearer that this is not about selective or basic health care interventions – the ultimate goal must be to deliver comprehensive primary health care to all.  The ambition to expand access to health care for the poor should also be greater and not stop at 80% coverage. Our collective priority must be financing and delivering services to reach all people and especially the poorest and most vulnerable 40%.

Oxfam especially welcomes the focus on equity principles and recognition by the World Bank that countries need to prioritize policies that actively redistribute resources and reduce disparities. UHC reforms must be explicit about reducing inequality in access to health services, so that everyone has the same financial protection and access to the same range of high quality health services according to need and not their ability to pay. Equity must be designed into the system from the beginning with governments and donors ensuring that the poor benefit at least as much as the better off at every step of the way towards universal coverage. Oxfam would like to see the World Bank playing a more pro-active role in helping Governments to ensure that funds for health are raised equitably, and actively redistributing resources.

Oxfam welcomes Jim Kim’s support for UHC in the post-2015 development framework and this is something we urge all world leaders to embrace. Universal health coverage provides the opportunity to accelerate progress on the health-related Millennium Development Goals, address the growing burden of non-communicable diseases, and most critically to move towards a more comprehensive approach to deliver on the right to equitable and affordable health care for all.

We caution against the World Bank Group ongoing promotion of an ever-increasing role for for-profit companies in delivering health care in poor countries (primarily through the IFC). Those countries that have been successful at reaching the poor at scale and delivering on these new targets set by the Bank have done so by prioritizing the scaling up and strengthening of public health care delivery.

Related blogs

Universal Health Coverage: key to the success of the World Bank’s new vision

In sickness and in wealth: The case for universal health care

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I read a story earlier today of someone taking an unpopular stand in favor of doing the right thing. (I don't mean to tease — I may post about this separately later. But I'm resisting the temptation to go into the details right now because I've decided to clamp down on my discursiveness in hope of occasionally actually finishing a post.) Their values, and how they expressed them, reminded me of some old-school political rhetoric — so old I learned it from my parents, who learned it when they were young, and had me when they were old. So I found myself thinking about my parents early this morning, hours before I realized today is Mothers' Day. And when I did, the circumstances of my thinking about my mother earlier immediately told me how to best honor her memory this Mothers' Day.

The founder of Mothers' Day — as must surely be the case with the founders of every American holiday not invented by Hallmark — would have little but disdain for what it has become. And my mother would totally have her back.

I'm sure some of you must be fans of Nate DeMeo. Or perhaps you remember my transcribing and posting to my LJ his mediation on the Orlando killings, A White Horse, last year. DeMeo may well be America's best non-fiction storyteller — certainly a contender. And as it happens, one of the first episodes of his The Memory Palace was about the founder of Mothers' Day.

(I will once again transcribe it for those of you who who can't abide spoken-word art. For the rest of you, skip my transcript and just listen to the original by clicking the title below. Or read along while listening. Nate DeMeo is a masterful writer, certainly. But his mastery of the storytellers' art can only be fully appreciated aurally. And this story is barely four minutes long.)

International Brotherhood of Mothers

Anna Jarvis loved her mother. And because she loved her so much, mothers around the world get flowers and cards and candy and hugs from their kids every May. Which must have Anna Jarvis spinning in her grave.

She was born in 1864 in West Virginia to a woman whose name was also Anna Jarvis. And her mother, Anna Maria to her daughters' Anne Marie, was a remarkable woman. The elder Anna was a feminist and a progressive and a bit of a socialist before any of those words meant anything. In Virginia, in the middle of the nineteenth century — back before the phrase West Virginia meant anything — she traveled throughout Appalachia, organizing women's groups:  teaching them about basic health, and how to demand workers' rights — after teaching them what those rights were in the first place. During the Civil War she brought women together to tend the sick and wounded soldiers, regardless of whether they wore blue or gray. After the war, with her baby Anna in her arms, she held meetings of mothers on both sides. In these proto-group-therapy sessions — a finding-closure-through-shared-grieving kind of thing — she promoted something called Mothers' Work Day. This wasn't mother-apostrophe-s — so not your mother — but mothers' — s-apostrophe. Mothers plural. A collective of mothers.

It was a radical idea:  Let's take a day — and it would be a day of demonstrations and political consciousness-raising — not of flowers or spa gift-certificates.  Let's take a day and recognize that what mothers do is work. And let's organize those workers the same way that people were starting to do with mines and mills and factories.

This was the work of her life. And when she died, in 1905, her life became the work of her daughter's life. Anna Marie — the younger Jarvis — was 29 years old and single, with no child of her own1. She was devastated by her mother's death, and at her funeral she handed out hundreds of carnations: one to each of the mothers in the congregation. She picked up the torch of her own mother's cause. And wouldn't put it down for the rest of her life. She delivered speeches. She published pamphlets. She wrote to governors and newspaper editors; senators, mayors — anyone in power. All in a campaign to get the government to recognize Mothers' Day.

And she succeeded. And failed at the same time. People loved the idea of a Mothers' Day — because people loved their mothers. And importantly, people loved the story of Anna Jarvis loving her own mother. It was a national holiday by 1914. And Jarvis kept going, talking about her mother and Mothers' Day all over the world. And for people all over the world — maybe wondering why they'd grown apart from their own mothers; maybe wishing their own children would thank them once in a while — for people all over the world, Anna Jarvis became the Platonic ideal of the devoted daughter. And they wrote to her. So many wrote to her to thank her — to unload to her about their mother-child relationships — that she had to buy a second house next door in which to store her correspondence. Mothers' Day would roll around every year, and Anna Jarvis — a woman with no child of her own — would get flowers by the score. Heart-shaped boxes of candy by the carload. Which made Anna Jarvis furious.

The holiday — designed to continue her mother's lifetime of effort working toward social justice and collective action — had gone commercial. Anna had thanked her mother by devoting her life to building a kind of living memorial. And it felt like all she'd accomplished was making it easy for people to go and thank theirs with a pre-packaged sentiment in a penny greeting card.

And so she railed against it for the rest of her life. Spending all of her modest savings on campaigns against the commercialization of Mothers' Day. Filing lawsuits to stop Mothers' Day celebrations. Condemning confectioners. Fighting florists. But the candy kept coming. And the flowers didn't stop. And when she died, penniless and blind, at the state sanatorium in Pennsylvania in 1948, her room was filled with Mothers' Day cards.

My mother taught me the value of collective action --- that only by pulling together do we all make way. And she taught me that when we fail to remember we're all in the same boat is when we are swept onto the rocks.

1  Yes, I noticed the disappearing dozen years. I've confirmed the facts: Anna Marie Jarvis was born in 1864; her mother died in 1905. Beyond that, I figure my job here is to transcribe, not edit.

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          John S. Toll        
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25th President of Washington College



  • B.S.Yale University, 1944
  • Ph.D. Princeton University, 1952

After receiving his bachelor's degree in physics with highest honors from Yale University in 1944 and serving in the Navy during World War II, Dr. Toll completed his Ph.D. in physics at Princeton, where he helped to establish Project Matterhorn, now known as the Princeton Plasma Physics Laboratory. In 1953 he joined the University of Maryland faculty and served for thirteen years as chair of the Department of Physics and Astronomy.


In 1965 Dr. Toll became the first president at the State University of New York at Stony Brook. By the time he left, the school of 1,800 students had been built to one of 17,000 students and, in addition to arts and sciences and engineering, they had added schools of public affairs, medicine, dentistry, nursing, allied health professions, basic health sciences, and social work. For his work there, Dr. Toll was listed among "100 Who Shaped the Century" by Newsday, the principal newspaper of Long Island, New York. The gift club of benefactors there is named for him.

<em>Visiting campus in 1999, former President George W. Bush (pictured with College President John Toll) helped commemorate the 200th anniversary of the death of George Washington.</em>


In 1978, the University of Maryland invited Dr. Toll to return as President. At that time, he presided over a system of five campuses. Ten years later, at the request of then-Governor Schaefer, Dr. Toll headed up the merger of Maryland's two public multi-campus university systems. This led to the founding of the University of Maryland System, with Dr. Toll named as Chancellor. Though he left that post in 1989, Dr. Toll still serves as Chancellor Emeritus. In 2002, the University named its physics building for him.

During his early years at the University of Maryland, Dr. Toll had been involved in the founding of the Universities Research Association (URA), a consortium of 34 member universities with research programs in high energy physics, formed to build and to operate the National Accelerator Laboratory. In 1989 Dr. Toll became president of that group, whose membership has now expanded to 80 universities.

Toll is credited with redefining Washington College as one of the nation's premier institutions of higher education. During his presidency, Dr. Toll elevated Washington College's national reputation, strengthened its academics with new programs and general education requirements, invested in the physical plant, and directed the single largest fundraising campaign ever conducted by any undergraduate college in Maryland. Before Dr. Toll arrived in January 1995, the College had experienced three straight years of budget deficits. Dr. Toll balanced the budget every year he was in office, and by the end of his tenure had more than quadrupled the endowment. By his own account, his decade at Washington College (1995—2004) ranked among the most professionally productive and personally rewarding of a career in higher education that spanned six decades. 

At 71, the former Chancellor of the University of Maryland System agreed to serve as Acting President through a transitional period, and then the Board of Visitors and Governors asked him to stay on. After working at major public research institutions, Dr. Toll said he was impressed that undergraduate students here could conduct research with faculty members in much the same way graduate students do. He proved adept at raising money to support that kind of student/faculty collaboration. With an original campaign goal of $72 million, the Campaign for Washington's College surpassed its target by nearly 44 percent, bringing in total contributions of $103.4 million. Under his leadership, the College's endowment assets grew from just under $27 million to more than $112.4 million.

Upon the conclusion of his presidency his legacy is defined by the Washington Scholars Program, a merit scholarship program that now supports more than half of all students enrolled at the College, a $20 million science facility, and an array of academic initiatives that includes two new centers that play to the College's strengths—its history as the first college founded in the new nation and its setting within the Chesapeake Bay watershed.

Enhanced academic programs with five new majors and the creation of two new centers—the C.V. Starr Center for the Study of the American Experience and the Center for the Environment and Society—that combine traditional academic programming with community outreach, engagement and research opportunities for students.

Renovation and expansion of the College's physical plant with the construction of two new academic facilities, a $20 million science teaching and research complex, 11 new student residence halls, and the renovation of numerous existing residence and academic buildings. The value of the physical plant will grew from $30 million in 1995 to over $70 million in 2004.

Under his leadership, Washington College gained national recognition and greater academic reputation as evidenced by the rising appraisal of Washington in U.S. News & World College Report and other college guides, as well as the addition of a chapter of Sigma Xi, the national scientific research society. Dr. Toll's wife, the former Deborah Ann Taintor, had a career in economics and journalism before becoming involved in higher education as the wife of a university president. She has worked as a leader for organizations in support of journalism and the arts. The Tolls have two grown daughters.

          Continuing the Case for Health Care Reform        

Fareed Zakaria is one of the most balanced, sensible reporters and commentators on international affairs going today. Because of this, he brings a global perspective to American domestic issues that many of the pundits lack. In this week's Time Magazine, he has a commentary entitled, “Health Insurance Is for Everyone” (CNN shows about half the article, the entire piece is on Time’s website that is accessed by subscribers).  In it he writes,

The centerpiece of the case against Obamacare is the requirement that everyone buy some kind of health insurance or face stiff penalties--the so-called individual mandate. It is a way of moving toward universal coverage without a government-run or single-payer system. It might surprise Americans to learn that another advanced industrial country, one with a totally private health care system, made precisely the same choice nearly 20 years ago: Switzerland.

Switzerland is not your typical European welfare-state society. It is extremely business-friendly and has always gone its own way, shunning the euro and charting its own course on health care. The country ranks higher than the U.S. on the Heritage Foundation's Index of Economic Freedom.

Twenty years ago, Switzerland had a system very similar to America's--private insurers, private providers--with very similar problems. People didn't buy insurance but ended up in emergency rooms, insurers screened out people with pre-existing conditions, and costs were rising fast. The country came to the conclusion that to make health care work, everyone had to buy insurance. So the Swiss passed an individual mandate and reformed their system along lines very similar to Obamacare. The reform law passed by referendum, narrowly. The result two decades later: quality of care remains very high, everyone has access, and costs have moderated. Switzerland spends 11% of its GDP on health care, compared with 17% in the U.S. Its 8 million people have health care that is not tied to their employers, they can choose among many plans, and they can switch plans every year. Overall satisfaction with the system is high.

Zakaria continues,

The most striking aspect of America's medical system remains how much of an outlier it is in the advanced industrial world. No other nation spends more than 12% of its total economy on health care. We do worse than most other countries on almost every measure of health outcomes: healthy-life expectancy, infant mortality and--crucially--patient satisfaction. Put simply, we have the most expensive, least efficient system of any rich country on the planet. Costs remain high on every level. Recently, the International Federation of Health Plans released a report comparing the prices in various countries of 23 medical services, from a routine checkup to an MRI to a dose of Lipitor. The U.S. had the highest costs in 22 of the 23 cases. An MRI costs $1,080 here; it costs $281 in France.

In 1963, Nobel Prize--winning economist Kenneth Arrow wrote an academic paper explaining why markets don't work well in health care. He argued that unlike with most goods and services, people don't know when they will need health care. And when they do need it--say, in the case of heart failure--the cost is often prohibitive. That means you need some kind of insurance or government-run system.

Now, we could decide as a society that it is O.K. for people who suddenly need health care to get it only if they can pay for it. The market would work just as it works for BMWs: anyone who can afford one can buy one. That would mean that the vast majority of Americans wouldn't be able to pay for a triple bypass or a hip replacement when they needed it. But every rich country in the world--and many not-so-rich ones--has decided that its people should have access to basic health care. Given that value, a pure free-market model simply cannot work.

In the campaigns for president, it seems that the conservatives have changed their tunes on requiring mandate for everyone to be included in health insurance. Zakaria observes,

Catastrophic insurance--covering trauma and serious illnesses--isn't a solution, because it's chronically ill patients, just 5% of the total, who account for 50% of American health care costs. That's why the Heritage Foundation, a conservative think tank, came up with the idea of an individual mandate in the 1980s, proposing that people buy health insurance in exactly the same way that people are required to buy car insurance. That's why Mitt Romney chose this model as a market-friendly system for Massachusetts when he was governor. And that's why Newt Gingrich praised the Massachusetts model as the most important step forward in health care in years. They have all changed their minds, but that is about politics, not economics.

He concludes,

When listening to the debate about American health care, I find that many of the most fervent critics of government involvement argue almost entirely from abstract theoretical propositions about free markets. One can and should reason from principles. But one must also reason from reality, from facts on the ground. And the fact is that about 20 foreign countries provide health care for their citizens in some way or other. All of them--including free-market havens like Switzerland and Taiwan--have found that they need to use an insurance or government-sponsored model. All of them provide universal health care at much, much lower costs than we do and with better results.

          By: kristen        
My best friend’s mom is a simple, gifted cook. Brussels sprouts roasted with olive oil; sautéed chard from their garden; salmon, from the farmers market fishmonger, grilled on the barbecue; and pie made from the blackberries off their backyard vine are just a few of the hundreds of delicious, fresh and healthy things I’ve eaten at their house over the past several years. It might surprise you that although she knows how to “plan and shop for healthy food”, “cook it”, and even grow it (you didn’t mention that one) she’s enrolled in an obesity treatment program very similar to the one you speak of so derisively. It’s not just meal replacements (although they’re an important component: I’d challenge you to satisfy your daily nutritional requirements, in under 600 calories a day, on “organic bread, vegetables, and fruit”), it’s also intensive group and individual counseling around behaviour modification; and yes, regular medical monitoring to ensure participants stay healthy throughout the process. From my perspective, the program seems to entail a little something more than simply “throwing a few packets of crap” at participants. More importantly, and to the point, my friend’s mom is more mobile, and feeling better, than she has in years. So I say cheers to Kaiser for providing a whole constellation of weight loss resources that meet the diverse needs of their clientele — resources that encompass the sort of basic health education you propone above, as well as individual counseling and - of course - increased access to healthy, whole foods through on-site farmers’ markets.
          Estimated 77 million US adults have trouble understanding basic health info        
          Flo For Africa        

January 20th at 9:30am

Karma Class at Pure Hot Yoga.

Join Kelly King for a fun up-beat Flo class with African inspired music. This will be a one time karma class and donations going towards Kelly’s one year of volunteering with Hands at Work. The goal of Hands at Work, a non profit organization, is to care for 100,000 orphaned and vulnerable children throughout rural African communities making food, education and basic health care accessible and sustainable.

This organization is dear to Kelly’s heart, and she leaves us March 9th for a one year…

          Why I am anti-Catholic, in one handy list.        

Because I am atheist people sometimes mistakenly assume that I am against people believing in God or I have disdain for people who pray or hope that God will bless them. Last time I spoke with my mother (hi mom!), she started a sentence by saying, “I know you don’t care about this, but I’m praying…” I wanted to interrupt her and explain that it’s not that I don’t care, and in fact the implication is offensive to me. I care very much. And anyways, it’s hard to deny the power of prayer and its healing role in people’s lives. You can be atheist and still respect other people's beliefs.

So the other day I posted this article to my facebook page, entitled, "Religious children are meaner than their secular counterparts, study finds." with this post: "This is the result of a system that tells you that it's ok to be an a-hole because you can confess it later, say a few prayers, and pretend it never happened. Oh, and that judging everyone and feeling superior to other people is ok too." And I say this not as a passive outsider but as someone who spent many hours in religion class (known as CCD) and in mass on Sundays. I was, to put it mildly, a religious kid. So while I recognise that my experience is not universal, I'd estimate that it is fairly typical, or at least unremarkable.

A family member of mine seemed to take it personally, commenting, “I don’t think I’m an a-hole. Do you?” You can recognise that a system contributes to the production of assholes without saying “All religious people are assholes.” You really, really can. I think people are confused about why I am so against the Catholic church and they can’t separate the corporation of Catholicism™ with individuals who believe in God or even who think they believe in the Bible (I say think because to be honest most people haven’t actually read the Bible for themselves and just think whatever their priests or religion teachers tell them the Bible says).

So here are just a few of the many reasons why I think Catholicism is bad for people and the world generally. To be honest, it was both boring and infuriating to think about, research, and write. I know this is a hard pill to swallow for people who persevere loving their religion and honestly believing that it's the only way to heaven. Well, if there's a heaven, I sure hope that participating in Catholicism isn't the only way there. And if it is, I'll take the nearest escalator going down.

1. Years and years of global child abuse at the hands of thousands of priests. But it's not even just about the abuse (sexual, physical, emotional). It's about the institutionalised cover-ups that occurred. When people started complaining about priests and their sexual misconduct, do you think the priests were fired and ex-communicated? Hell no. They were sent to other parishes. And guess what kind of places they were sent? Working class areas. Places where people didn't have as much agency and power. Places where people complained less. Everyone knew what was going on. You knew. I knew. The fucking Pope knew. Nothing was ever done. Maybe this kind of thing is why the Church teaches people to 'turn the other cheek.' Either way, thousands of victims' lives were completely ruined and they received no justice, and in many cases no apology. Many of them have committed suicide. The stories are heartbreaking, and no Pope has adequately addressed the issue. I guess I don't understand why Catholics aren't mass protesting about this. They just accept the infallibility of the Vatican. They just keep going to mass and giving tonnes of money to their churches. In my mind that's saying that everything is a-ok and it's just peachy that there was a mass cover up for decades of systematic rape and molestation of children. And if you don't believe in the top-down cover up of the abuse, then you haven't read enough about it.

I recently watched the film Spotlight. When that story broke, I was actually living in Boston and I actually had no idea how many priests and how many victims were involved. The scale, worldwide, is astounding. I honestly don't know how you can comprehend the heartless and systematic cover-up and still walk into a Catholic church, let alone give them a penny of your money.

2. Exercising control over educational systems and curriculum to spread harmful misinformation. Oof - where to begin with this one. Well, I'll start with the situation here in Ireland where in the year 2015 kids who aren't baptised in the Catholic church have a harder time getting into public school. Yep, public school is the one that's supposed to be free and available to all people. A person can be put last on a list to get into a school because they didn't get water poured over their head by some old dude chanting about original sin. The United Nations recently published a report saying Ireland needs to fix its discriminatory policies about their supposedly public education.

But Ireland aside, there are countless children all around the world whose access to education about health and science is being curtailed because of Catholicism's strange denial that things like evolution and sex ed are helpful subjects to know about. The upshot is that kids aren't left ignorant about healthy attitudes towards sex, sexual consent, sexual health, and healthy boundaries. Not to mention all those unwanted pregnancies and sexually transmitted infections. So much money goes into Catholic-endorsed abstinence-only education, despite the fact that countless studies show it simply perpetuates untruths and harmful myths about how the world and humans work.

2. Symphysiotomy. I never heard about symphysiotomy until I moved to Ireland in 2009. Basically, when a woman was having a difficult childbirth, for various reasons, doctors in Ireland wanted to avoid using Cesarean section because you can only have so many of those. If women needed to limit the number of kids they had for medical reasons, then they'd need to make contraception available. But contraception was illegal and the Catholic church wanted to keep it that way. So instead of giving C-sections, they sawed women's pelvises in half without their knowledge or consent. Women were leaving hospitals in wheelchairs, unable to walk, and having no idea why. Some didn't discover it until years later. And this practice continued until the 1990s. Imagine going into the hospital to give birth and coming out with your pelvis split in two. Can you guess how that went? If you want to have a good cry, check out the website of the Survivors of Symphysiotomy. You might say oh that's the doctors, but no. The doctors were acting as the arms of the church when they mutilated those women.

3. Magdalene laundries and mother and baby homes. It's easy to act like certain things that the church have done are ancient history, and aren't they so evolved because the new Pope was in a rock band or whatever. But the victims are still living with their trauma, and many of those that have died from crimes of the church are unnamed and hidden in the ground. There are some redress schemes in the form of pensions, but throwing money at people doesn't turn back the hands of time. Want to read something horrific? How about hundreds of dead babies thrown into a septic tank by nuns who didn't give a shit about them or the women who gave birth to them?

But that's actually just a blip on the institutions that were created for 'errant' women around the world. The last one closed in 1996. I don't know about you, but I was an adult in 1996. Many women were so desperate to escape that they literally died trying to climb their way out. And for what? Their own good, according to the church.

4. Anti-gay and anti-transgender bigotry. The Catholic church is still preaching that homosexuality is wrong and being transgender doesn't exist. People then use these teachings to beat and murder members of the LGBT community. Oh, and don't pretend that the Pope is all cool about the gays. He isn't. Honestly I'm really annoyed at how gullible people are at the Vatican's slick Public Relations techniques. The truth is that this new Pope isn't any different than any other -- he's just basically putting the same messages in different packaging to lull people into feeling as though the Vatican has made progress on social issues. They haven't. And meanwhile, people are suffering because of it. And if you think their attitudes about it have anything to do with the Bible, I hope you don't mind being stoned to death for using the lord's name in vain because that's in there too.

5. Inherent misogyny and sex negativity ingrained not just in Bible stories, but the church hierarchy itself. What's the big deal about women not being able to become priests, bishops, deacons, cardinals, or any other position of power in the church? It's the same big deal when women aren't in positions of leadership everywhere: decisions are made that affect them without their input or consent. Policies are put in place which endanger their lives. For example, as with the aforementioned symphysiotomy. Or birth control. Or abortion. You can't count the number of women around the world who die each year from lack of abortion services. This is to say nothing of the hetero-normative gender roles that the Church promotes, whether through the Bible or otherwise. But, honestly, I hate to even bring up the Bible at all because there is some seriously messed up stuff in there that only a psychopath would be ok with. The Church just picks and chooses which ones it's going to latch onto, and then sometimes 'interprets' the Bible to suit its opinions, when in actual fact that's not really what the Bible says when you study it. Case in point: abortion. Jews tend to have a different take. According to about a thousand years of rabbinical study, the Bible doesn't actually forbid it.

7. Cultural imperialism through missionaries and charity. First off, why can't Christians just let people have their own beliefs and Gods? I know, I know - they think they're saving people's souls. But I actually don't think it's about that. I don't think there's anything altruistic about it, to be honest. I'm no expert on this subject. And sure, they build houses and do charity work, but if it comes with strings attached, then I personally don't view it as charity. If you go back in history to the genesis of missionaries, you'll find that it was more about politics and making loads of money than God anyways. They prey on disadvantaged people with little agency, and have been doing so for thousands of years.

8. Use of wealth to fund causes of inequality and healthcare prevention. Each year, thousands -- actually it may be millions, but I'm too lazy to look it up -- of dollars are spent by Catholics in America to try and curtail the rights of people in places like Ireland. Youth Defence is one group funded in such a way. Life House is another. They spread horrible lies and misinformation about abortion and actively try to keep women from accessing basic health care and human rights.

9. Culture of secrecy and dictatorship. Do I really need to explain this one? Shame and browbeating is what the Church is best known for. Be ashamed of your bodies, your sexualities, conform to gender roles, do what we say, believe in our infallibility, and only tell God your secrets. Fuck. that. shit.

I know there are so many other things I should list. But frankly, I've spent enough time on this.
But really what I want is for people to stop judging me for not accepting that religion is this benign institution. It doesn't exist to send people to heaven. I'm sorry but it just doesn't. It exists to exert control over people's lives. End of story. If you believe in God and it's helpful for you in your life, that's great! I'm happy for you! But I think people need to take a look at the actual good vs. harm being done by Christian religions and ask whether it's worth being part of.

Finally, I entreat everyone to listen to the wonderful and hilarious Julia Sweeney talk about her journey to atheism. She talks about how reading the Bible made her lose her faith, and it's brilliant.

          Why You Should Be a Pro-Choice Activist, No Excuses        
Being involved and caring about pro-choice activism sometimes feels gauche and illicit. It feels, ironically, unfeminine. It's demeaning and has often made me fear for my safety. As such, I don't generally put my activism, through which I've learned many desirable work skills, on my CV, to prevent possible discrimination. And while it's such a big part of my life -- how I spend my time, with whom I spend it, and how I think about the world in general -- I don't often mention it to people I've just met unless I'm sure that they are pro-choice.

This is all kind of incongruous because part of the work I do revolves around de-stigmatising abortion. You'd think I'd practice what I preach. And I do...but not always. To me, this illustrates the power of the patriarchal claim over women's bodies and behavior. Fighting for the most basic right, control over your own body, should be just one of those things we all agree is important.

Except, it's not one of those things.

And that's because some people do have control over their own bodies, and they don't really want to think about what it means that a great many others do not. Generally, if you are a man, or if you have enough money to take time off work and travel, if you have access to contraception, or if you have never been and never will be raped, never get cancer or another terminal illness while pregnant, or never have a pregnancy with a fatal foetal abnormality, then you should probably count your blessings and it's quite likely you are calmly chillin' and living your life feeling pretty (relatively) secure in your bodily autonomy. And you may not think you need to think about the indelicate issue of abortion.

Even just the word sounds so...harsh and impolite. Abortion. It's not pretty and soft like the word meadow.

So if you don't need to worry about access to abortion, for whatever reason, good for you. And maybe you aren't the kind of person who cares about the less fortunate. If that's the case, go ahead and stop reading right now. But if you care about the world and human rights, even a little bit, you'll start thinking about abortion a lot more. Because it turns out that fighting for abortions rights is about a LOT more than abortion, and if you think otherwise, it's time to get your head out of the sand and look around.

I was recently disturbed by a conversation I had with someone about the Miss Y case in Ireland. I was explaining that Miss Y was a woman who immigrated to Ireland after being raped in her previous country. After she arrived, she discovered she was pregnant from that rape. It's a long story, and I won't go into every detail here, but she was suicidal, as you can imagine. Despite the new law that supposedly allows suicidal women to access abortion, she was denied, despite going on hunger and thirst strike. In fact, she was force fed and strung along, made to believe she would be able to abort. Meanwhile, the foetus had a team of lawyers. Literally. Basically, they stalled her abortion access until her pregnancy was at just over 25 weeks, at which point they presented her with a supposed solution: cesarean section to deliver the baby. Imagine having to deliver the offspring of your rapist without your consent. They took the words "termination of pregnancy" and twisted them. Sure, they terminated the pregnancy. But not in the way that was best for the patient. She is permanently traumatised.

As I told the story, it wasn't until the part where she had the C-section against her will that my listener chimed in. "I mean, nevermind about the abortion, that's a real violation of human rights!" they said. I've rolled that response over and over in my mind. It never occurred to me that some people aren't making the connection between abortion access and human rights.

When the law or lack of access forces some people to be pregnant, but not other people, it's a violation of human rights. If some people are denied basic health care, but not others, it's a violation of human rights. When you get to a point where a person is having a baby cut out of her that she doesn't want to give birth to, a serious violation has already happened.

I want to have control over what happens to my body at all times. Don't you? I don't want to be punched, raped, stabbed, shot, operated on, or pregnant against my will. There are lots of reasons why people don't want to be pregnant. Too many to name. You might think none of them matter. You might think some of them matter. You might think only one or two of them matter. But that's your business. Personally, I would be overjoyed if smoking was magically eliminated across the world and I also think that smoking is morally wrong. But that's my business and my belief that I acknowledge shouldn't be pushed onto other people. Morality has nothing to do with abortion. It has to do with the fact that people who don't want to be pregnant become enslaved when they are forced to carry that pregnancy. Forced pregnancy is a human rights issue.

Women seek access to abortion. Women have always sought access to abortion. Women will always seek access to abortion. Whether you think it's morally right or wrong. And guess what happens when governments make it difficult to access abortion? Women die. Being denied the right to be pregnant or to not be pregnant forces women to terrible measures.

And while I'm here, I just want to state the obvious: abortion is not murder, and I feel sorry for you if you've been brainwashed by religious child abusers. You've obviously never actually read the Bible. (And p.s. foetuses do not feel pain.)

You know what, though? That's not even what I want to say.

If you don't care about your own rights, or the rights of people you don't know and will never know, and if you aren't willing to give up some of your spare time to fight for those rights, actually reading this may not make a bit of difference. It's just that abortion access is being etched away around the world, and fast. And I don't want to sound all paranoid and conspiracy theorist, but they're not just going for our abortion rights. They're going for complete control over women's bodies.

If you think I'm being hyperbolic, take this case from a few weeks ago in Ireland, where a brain dead woman was kept on life support because she was pregnant.  Or the many, many cases where women who've had miscarriages have been criminally charged.

The most important thing you need to understand is that even if you live in a country where abortion is "legal," unless it's available to everyone, no matter where they live, no matter how much extra cash they have, no matter what their age, then its legality is null and void. Legality without access is useless. According to an article in the Guttmacher Policy Review by Boonstra & Nash, in the United States, "more state abortion restrictions were enacted in 2011 - 2013 than in the entire previous decade." And they're not talking about a couple of laws. In those three years, a whopping 205 anti-abortion laws were passed. Considering there are only 50 states, that's kind of...staggering.

If you're in America and you feel all comfy with Roe vs. Wade, just take a look at Spain. Last year, they came dangerously close to outlawing abortion, hoping to model themselves after Irish law (which effectively and logistically outlaws abortion in all cases). According to Boonstra & Nash, "The majority of women now live in [US] states hostile to abortion rights: Between 2000 and 2013, the proportion of women living in restrictive states almost doubled from 31% to 56%." Yes, the "majority of women." (For more info on what this means, read this article by Katie Klabusich.) But the women most affected by anti-abortion laws are poor women (which includes those with residency or documentation issues), women in abusive situations, and women who are ill (physically or mentally). 

YOU need to be advocating for those women, and all women. If you don't, who will? On top of abortion access, the right wing money machine is making more and more progress gaining control over women's access to sexual health care, birth control, domestic violence aid, supports in cases of rape, and more. Reproductive rights are human rights. Stop thinking that this problem isn't going to get much worse. The Catholic church and the rich white dudes in public office have money at hand that's probably inconceivable to most regular people. And with that money comes control over public opinion from the pulpit to the news stand. They throw us into the "good abortion/bad abortion" trap and try to distract us from demanding our rights by trying to put their hypocritical so-called morals on us. It's ridiculous but it's happening and they are winning.

STOP thinking that social media "activism" is going to stop anti-abortion laws. Find out who your lawmakers are and contact them, letting them know that bodily autonomy is important to you and that you're watching how they vote. Find out what pro-choice activist groups are in your area and give them money and time. Keep tabs on demonstrations happening in your area and attend them with signs that show your pro-choice spirit. Look up organisations that help fund women in areas with no access to abortion to travel, take time off work, and pay for child care and see if you can get involved or donate. Find out what the laws are in your state or country and then reach out to groups working to improve those laws and see if you can lend a hand. 

I'm just so tired of seeing that the majority of the people I know are pro-choice in some form or another, yet they do nothing but complain on facebook and twitter when these anti-abortion laws are passed. It's all well and good to be working towards personal success and happiness, but if you leave those less fortunate in the dust, how can you really feel good about it? 

Some resources to check out:
Womancare Global
 RH Reality Check
Abortion Rights Campaign

          Stop being afraid of admitting you are Pro-Choice. We need you.        
When I was a teenager in the late 1980s, I was fortunate enough to have a fantastic teacher, Mrs. Christenson, who taught a Women's Studies in our very small public high school. How she managed to convince the school in our conservative little town to teach such a progressive course, I'll never know, but I felt incredibly honoured and privileged to take part. A book she recommended was Our Bodies, Our Selves, by the Boston Women's Health Book Collective. This book became my health bible, answering questions I wouldn't have dreamed of asking another human being, let alone my doctor. It allowed me to hear women's voices, read women's real life experiences, and opened a door into how feminism matters in the lives we lead, not just as a concept.

Today, I'm reminded that feminism's primary concern is one of human rights. But because so many of the rights that are denied women are tied to our reproductive organs, people shy away from talking about it. Abortion is not a pleasant thing. Most people, including me, don't enjoy bringing up the subject. However, abortion rights are some of the most basic rights that women have fought for and still need to keep fighting for.

In Ireland, a woman cannot get a legal abortion for any reason. Not if being pregnant is endangering her life. Not if she was raped. Not if she was raped by a family member. Not if her foetus has a fatal abnormality and will die the minute it is born. Not for any reason. Twenty years ago, a fourteen year old girl who was pregnant from being repeatedly raped by her neighbor won a historic case against the attorney general for the right to an abortion because her pregnancy caused "a real and substantial risk to her life." But no legislation was ever enacted. In other words, although the legal right technically exists, there is no way to actually avail of that right. Women still cannot, even to save their own lives, obtain an abortion in Ireland.

It doesn't take Einstein to figure out what results: the unnecessary deaths of women. This morning, a news story broke telling a horrific tale of a 31-year-old woman named Savita Halappanavar  who presented with a miscarriage. It was quite clear that the pregnancy was not viable. However, despite international recommendations to the contrary, and despite the woman's desperate pleas to terminate her pregnancy, the medical staff refused to remove the foetus until it died inside of her, citing that "This is a Catholic country." She developed an infection and died a painful death. Now a family is mourning for a woman who should be alive today.

Of course today the media is flooded with this story. However, while the story was held up in the Irish Times' legal department for at least 24 hours or more, they decided to run an opinion piece entitled, "Abortion is Never the Basis for a Humane or Compassionate Solution"  knowing full well that the next day they'd be running a gigantic story about a woman who died as a result of being denied abortion services. Today, in tandem with this story, they have also decided to run an article headlined, "Death as a result of infection during miscarriage rare" as if to say, "Hey guys! This, like, almost never happens, so what's the big deal?"

Another thing you should know is that abortion is not just unavailable. It's actually outlawed in the actual Irish Constitution. So to legalise it in any capacity, we can assume, would require a change in to the 8th Amendment. This past weekend, there was a referendum to change the constitution of Ireland for another issue, called the Children's Referendum. Turnout for that vote was very low, but it was passed. What do you think The Irish Times made of that? Why, this of course: "Low Turnout a Lesson Not to Tinker with Constitution." Keep in mind that this "analysis" was printed with their full knowledge of the floodgates that were about to be unleashed by the news of Savita Halappanavar's tragic death. So while they report the news, they manage to get their propaganda into the message, which is that we shouldn't legislate on the X case and we shouldn't allow women avail of their rights to abortion services, not even to save their lives.

I can't help but think back to my experiences during the 1992 Brookline Massachusetts clinic shootings.  It felt horrible and wrong to hold up the death of someone I knew and worked with as a rallying cry. But I knew that it was necessary, and it was right. Today, we must all remember that Savita Halappanavar was a person, a person who was loved, and who is now being grieved for. But we must also think of all the women we know living in Ireland of child bearing age, and speak out so that this doesn't happen anymore. No matter how rare they claim it is, it happens. Women die because their rights are being denied. Basic health care is being denied. And everyone, all around the world, needs to start talking about it.

Like I said, abortion is not a fun subject. No one enjoys having to talk about it. But talk we must. March we must. And shout. And write. Do your part, even if it's just sharing Savita's story. Even if you think everyone already knows. Have the courage to bring up this sore subject. Stop being afraid of what people will think of you. Start thinking about the people you love who are trying to have families, like the Halappanavars. What if this happened to me? What would you do then? Now, do it.

If you are in Ireland, come to the Dail today at 6pm, or to the vigil on Saturday. Make your voice heard!

          Comment on Media Coverage of American Healthcare by consider        
Why not have basic healthcare for all citizens? It's one of the basic functions: like roads, fire departments, fitness centers, schools, and even the defense of a country, that people pay taxes for. People can choose to pay for additional healthcare. The countries that you listed are all very different, however, I am glad that you are able to travel. It's really a fabulous opportunity to see how others live. It always makes me very appreciative and thankful to be able to expand and build upon what I have experienced.
          How Liberia Is Working To Deliver Healthcare To More Than A Quarter Of Its Population        
By training and deploying community health assistants to remote corners of the country, the government aims to deliver basic healthcare and reduce child mortality.
          Fallout: From Healthcare Equality to Existential Threat        

by Jenji Cassandra Learn

This New Year’s Day—Sunday the 1st, 2017—was supposed to be the first day that I and people like me had equal access to healthcare in America. It was supposed to the first time we were regarded as equal to our fellow citizens and not required to pay out-of-pocket for basic healthcare needs, or even surgery, without any help from insurance providers that the rest of America depends on and that we are never the less obliged to give our money to even while they regard us as non-entities and less-than.…

          Transgender Service Members’ Medical Costs Are Not a “Burden”        

On Wednesday morning, President Donald Trump used his favorite policy forum to announce that he was reversing the Obama administration policy of opening military service to transgender individuals. “Our military,” he tweeted, “must be focused on decisive and overwhelming victory and cannot be burdened with the tremendous medical costs and disruption that transgender [sic] in the military would entail.”

The word to focus on in this statement is burdened. Not only does the president think transgender service members would be a distraction, but he also believes their health care would be so exorbitantly expensive that their service to our country would not be worth it.

A 2016 paper by the Rand Corporation titled “Assessing the Implications of Allowing Transgender Personnel to Serve Openly” estimated that about 2,450 transgender people are on active duty (out of 1.3 million active-duty service members altogether), and of that number, around 29 to 129 service members would seek care related to a gender transition in any given year. The total cost of their health care would increase overall expenditures on health care by between $2.4 million and $8.4 million annually, which amounts to a 0.04 to 0.13 percent increase in total active component health care expenditures. The true cost may even be lower; when the University of California system began to cover gender transition surgery in 2005, it only ended up covering 28 surgeries over a period of five years. By way of comparison, in 2014 the Department of Defense spent more than $84 million on Viagra and other medications to treat erectile dysfunction.

Are there costs associated with gender reassignment surgery? Of course, and like almost everything else in American health care, they can appear overwhelming at first glance. But the treatments are medically sound and warranted—paying for a gender transition is just as worthy a means of creating a strong military as paying for another service member’s mental health care or cancer treatment. The 2011 National Transgender Discrimination Survey found that 41 percent of transgender respondents had attempted suicide (as compared with 1.6 percent for the general population), in many cases due to lack of access to the transition services that successfully treat gender dysphoria. Recognizing transgender medical concerns as real and treatable (in the military and beyond) could give transgender individuals a greater chance of thriving.

The aforementioned survey also found that 20 percent of transgender individuals had served in the military; during the same period, 10 percent of the adult population of the United States had served. This survey was conducted before the military began to move to officially accept transgender service members, meaning that every one of those respondents had to serve while in the closet. Transgender people have assuredly been in the military for many years, and many more will continue to serve our country regardless of whatever edict regarding their status is issued via tweet.

What is at stake, then, is not whether transgender people will be allowed to serve but what sorts of lives they will be allowed to live while serving. Will they be pushed back into the closet, forced to hide their own identities at risk of losing their jobs and the ability to serve their country, or will they be acknowledged as fully human and extended the same basic health care rights that are extended to every cisgender service member? By shelling out millions for Viagra and other erectile dysfunction medications, we already recognize the importance of quality of life for those who would defend our country. To refuse to extend the same decency to transgender individuals has nothing to do with money and everything to do with our own lingering prejudices.

          Could a Tuberculosis Outbreak Happen Here?        

We like to think that tuberculosis is a public health issue exclusive to the developing world, but the disease has begun to resurface as a major concern in certain parts of the United States, too. Last year, for the first time in nearly a quarter-century, the number of TB cases in the U.S. actually increased. Some parts of the country, such as central Alabama, are now in the midst of a TB outbreak. In Perry County, for example, the disease infects people at a rate of 253 for every 100,000 people, compared to 2.5 per 100,000 in the rest of the state.

TB is treatable as long as the patient has regular access to medical care. However, there has been a long history of struggling to keep the disease under control—particularly for vulnerable patients with lack of access to health care. Because TB regimens may last many months, barriers to or interruptions in care can lead to unfinished treatments. This doesn’t just harm the patient; it can also lead to the rise of multidrug-resistant (MDR) bacteria.

This is more than just a frightening possibility for Dr. Edward Zuroweste, a physician in upstate New York who serves as the tuberculosis medical consultant to the Pennsylvania Department of Health and co-chief medical officer of the Migrant Clinicians Network, a nonprofit that provides care for migrant workers.

Zuroweste thinks a looming public health crisis could be emerging in other Southern states in addition to Alabama. He says he currently sees “a rapid rise in drug-resistant tuberculosis all along the Southern border,” where rates of MDR TB have historically already been high.

Zuroweste sees this as a direct result of unfinished treatments and is concerned that continued obstacles to care, particularly for the migrant population, might make the situation worse. Migrant workers already have a hard time accessing health care. And now, multiple reports have chronicled the way undocumented immigrants, migrant workers, and even legal immigrants have become too anxious to seek out health care over the past year.

Doctors who care for these vulnerable populations have been realizing that their ability to treat their patients is increasingly hampered by their inability to predict what effect immigration and health care policies will have on their work. Karen Mountain, CEO of the Migrant Clinicians Network, describes the immense pressure the organization has recently been experiencing. “We’ve been told to change our name for our own survival,” she says,  “and I as well as many of my colleagues have personally been asked why we waste our time trying to provide access for [these patients].”

At the same time, the current climate is making patients afraid to seek help or keep their appointments. And as news of Immigration and Customs Enforcement officials detaining patients in clinics and pharmacies spreads, fear is stopping many patients from tending to their most basic health care needs. Doctors from Johns Hopkins University penned an op-ed in the Baltimore Sun earlier this year that included these chilling scenarios:

As many local businesses, including prominent restaurants, closed in support of “A day without immigrants,” a Honduran man was detained by ICE at the Walgreens on Eastern Avenue where many of our patients fill their medication prescriptions. We had to scramble to contact our patients and change their pharmacy of choice to a safer option within Bayview Hospital.
On Friday, a patient called because he was running out of life-saving medications but was afraid to leave his apartment because ICE was in the neighborhood.

Unfortunately, these experiences are not limited to Baltimore. Zuroweste recently had a patient who was so concerned about being thrown in jail or being deported that he refused to go to the hospital for months. By the time he finally showed up to the emergency room, he had lost over half of his body weight.

These are individual stories, and none of them means that an outbreak is guaranteed to happen. Nor does it mean that if one does, it will be a direct result of immigration policies or the current political climate. But it is an important reminder that every decision we make has implications, direct and indirect. In this case, decisions about immigration are affecting access to health care, which runs the risk of resulting in new outbreaks of serious diseases like TB across entire communities.

The quality and effectiveness of the system as a whole suffers when people don’t feel safe seeing their doctors. Creating barriers to health care for vulnerable populations—whether in the form of frightened patients, concerned providers, or diminished insurance coverage—could inevitably have devastating and widespread effects. When sick patients have nowhere to turn, illnesses like MDR TB can quickly turn into public health disasters. And that affects us all.

Disclaimer: The opinions expressed in this article are solely those of the author and do not reflect the views and opinions of MedStar Health.

Daniel Marchalik is a urologist in Washington, D.C. He directs the literature and medicine track at the Georgetown University School of Medicine and writes a monthly column for The Lancet.

          John S. Toll        
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25th President of Washington College



  • B.S.Yale University, 1944
  • Ph.D. Princeton University, 1952

After receiving his bachelor's degree in physics with highest honors from Yale University in 1944 and serving in the Navy during World War II, Dr. Toll completed his Ph.D. in physics at Princeton, where he helped to establish Project Matterhorn, now known as the Princeton Plasma Physics Laboratory. In 1953 he joined the University of Maryland faculty and served for thirteen years as chair of the Department of Physics and Astronomy.


In 1965 Dr. Toll became the first president at the State University of New York at Stony Brook. By the time he left, the school of 1,800 students had been built to one of 17,000 students and, in addition to arts and sciences and engineering, they had added schools of public affairs, medicine, dentistry, nursing, allied health professions, basic health sciences, and social work. For his work there, Dr. Toll was listed among "100 Who Shaped the Century" by Newsday, the principal newspaper of Long Island, New York. The gift club of benefactors there is named for him.

<em>Visiting campus in 1999, former President George W. Bush (pictured with College President John Toll) helped commemorate the 200th anniversary of the death of George Washington.</em>


In 1978, the University of Maryland invited Dr. Toll to return as President. At that time, he presided over a system of five campuses. Ten years later, at the request of then-Governor Schaefer, Dr. Toll headed up the merger of Maryland's two public multi-campus university systems. This led to the founding of the University of Maryland System, with Dr. Toll named as Chancellor. Though he left that post in 1989, Dr. Toll still serves as Chancellor Emeritus. In 2002, the University named its physics building for him.

During his early years at the University of Maryland, Dr. Toll had been involved in the founding of the Universities Research Association (URA), a consortium of 34 member universities with research programs in high energy physics, formed to build and to operate the National Accelerator Laboratory. In 1989 Dr. Toll became president of that group, whose membership has now expanded to 80 universities.

Toll is credited with redefining Washington College as one of the nation's premier institutions of higher education. During his presidency, Dr. Toll elevated Washington College's national reputation, strengthened its academics with new programs and general education requirements, invested in the physical plant, and directed the single largest fundraising campaign ever conducted by any undergraduate college in Maryland. Before Dr. Toll arrived in January 1995, the College had experienced three straight years of budget deficits. Dr. Toll balanced the budget every year he was in office, and by the end of his tenure had more than quadrupled the endowment. By his own account, his decade at Washington College (1995—2004) ranked among the most professionally productive and personally rewarding of a career in higher education that spanned six decades. 

At 71, the former Chancellor of the University of Maryland System agreed to serve as Acting President through a transitional period, and then the Board of Visitors and Governors asked him to stay on. After working at major public research institutions, Dr. Toll said he was impressed that undergraduate students here could conduct research with faculty members in much the same way graduate students do. He proved adept at raising money to support that kind of student/faculty collaboration. With an original campaign goal of $72 million, the Campaign for Washington's College surpassed its target by nearly 44 percent, bringing in total contributions of $103.4 million. Under his leadership, the College's endowment assets grew from just under $27 million to more than $112.4 million.

Upon the conclusion of his presidency his legacy is defined by the Washington Scholars Program, a merit scholarship program that now supports more than half of all students enrolled at the College, a $20 million science facility, and an array of academic initiatives that includes two new centers that play to the College's strengths—its history as the first college founded in the new nation and its setting within the Chesapeake Bay watershed.

Enhanced academic programs with five new majors and the creation of two new centers—the C.V. Starr Center for the Study of the American Experience and the Center for the Environment and Society—that combine traditional academic programming with community outreach, engagement and research opportunities for students.

Renovation and expansion of the College's physical plant with the construction of two new academic facilities, a $20 million science teaching and research complex, 11 new student residence halls, and the renovation of numerous existing residence and academic buildings. The value of the physical plant will grew from $30 million in 1995 to over $70 million in 2004.

Under his leadership, Washington College gained national recognition and greater academic reputation as evidenced by the rising appraisal of Washington in U.S. News & World College Report and other college guides, as well as the addition of a chapter of Sigma Xi, the national scientific research society. Dr. Toll's wife, the former Deborah Ann Taintor, had a career in economics and journalism before becoming involved in higher education as the wife of a university president. She has worked as a leader for organizations in support of journalism and the arts. The Tolls have two grown daughters.

          Third of private rented homes fail basic health and safety standards, new analysis finds        
Exclusive: Millions of UK people living in rented properties with dangerous hazards, despite private rents soaring
          Submission for the Universal Periodic Review of Mali        


The human rights climate in northern and increasingly central Mali remains precarious as a result of abuses and intimidation by Islamist armed groups, bloody intercommunal clashes, surges in violent crime and rights violations by state security forces engaged in counterterrorism operations.  

Slow implementation of the 2015 peace accord and the failure to disarm thousands of combatants involved in the 2012-2013 armed conflict, deepened a security vacuum that increasingly has placed civilians in the north at risk. Meanwhile, from 2015, Islamist armed groups have increasingly carried out operations and abuses in central and southern Mali, including the capital, Bamako. 

The insecurity undermined efforts by the Malian government and its international partners to strengthen the rule of law and deliver basic health care, education, and humanitarian assistance. Persistent intercommunal conflicts in central and northern Mali left dozens dead and were exploited by armed groups to garner support and recruits.

The Malian security forces responded to attacks by Islamist armed groups with counterterrorism operations that often resulted in arbitrary arrests, summary executions, torture, and other ill-treatment. In general, abuses by the security forces have gradually decreased. They have been either unable or unwilling to protect citizens from rampant and rising crime, but have made meaningful effort to respond to communal violence.

Malian authorities made scant effort to investigate and hold accountable those implicated in recent abuses or those committed during the 2012-2013 armed conflict. The criminal justice system and other rule-of-law institutions remain weak. Corruption was endemic at all levels of government, further impeding Malians’ access to basic health care and education.

  1. Malian Security Force Violations

During its 2013 UPR review, Mali accepted to “guarantee the respect for human rights and international humanitarian law by the defense and security forces.” While serious human rights abuses by the security forces have steadily declined since 2013, abuses including extrajudicial execution, enforced disappearance, torture, and arbitrary detention have persisted.  

The vast majority of these abuses were committed by the Malian army during counterterrorism operations in Mali’s northern and central regions, usually during ad hoc interrogations in the first two days after detention, though the soldiers are not authorized to interrogate detainees. In several cases, officers were present during the abuse. The vast majority of detainees with whom we spoke said the abuse stopped after they were handed over to government gendarmes who usually provided medical care to the detained.

Since 2013, a Human Rights Watch researcher has conducted in-depth interviews with several hundred men detained for their alleged support for or membership in Islamist armed groups in central and northern Mali, and scores of other witnesses to serious abuses by the Malian security forces. 

During this time, Human Rights Watch documented the extrajudicial killing of 43 detainees; the enforced disappearance of 17; and the severe mistreatment of over 70. 

With respect to torture and mistreatment, Mali accepted to adopt and implement measures to ensure that international human rights standards are observed by the Malian Armed Forces, in particular the absolute ban on torture and ill-treatment. Scores of detainees interviewed between 2013 and 2017 told Human Rights Watch that they had been severely mistreated during interrogation by army soldiers. The detainees, many of whom had scars and showed visible signs of torture, described being hogtied, pummeled with fists and gun butts, kicked, suspended from trees, burned, and subjected to simulated drowning akin to “waterboarding” and other mock executions. Several had broken bones, lost teeth, or permanently lost their hearing or sight. They were also routinely denied food, water, and medical care.

Frequent acts of bribe-taking, extortion, and theft from detainees and civilians by the Malian security forces has undermined confidence and been exploited by Islamist armed groups to garner support and recruits.

During its 2013 UPR, Mali committed to undertake effective and impartial investigations into all reports of extrajudicial executions, torture, other ill-treatment and violence by its security forces and to ensure that perpetrators are brought to justice. This has not occurred. Despite having been made aware of serious violations, by way of letters, reports by human rights groups and the media, and meetings with high-level government officials, the military and civilian justice systems made next to no effort to investigate and hold to account soldiers implicated in violations against detainees. However, progress was made in staffing and equipping the Military Justice Directorate in Bamako. 

Mali committed to taking measures to “provide for the effective protection of human rights and due process of law.” While nearly all detainees accused of supporting Islamist armed groups are promptly brought before a judge, several have been nevertheless held without respect for due process within the confines of the state security services, which is not an official detention center. 

Mali accepted to provide “human rights training to law enforcement officials and judges to reinforce a culture of human rights.” There has been considerable progress in this area.  The Malian army consistently trains personnel in international humanitarian law (IHL) and has increasingly worked to ensure provost marshals are included in field operations so as to ensure IHL is respected. Both of these efforts appear to have led to a reduction in abuses against detainees.

Mali accepted to “take all necessary measures to avoid collective and arbitrary punishments of presumed rebels' collaborators,” however this appears to be a continuing problem. Lawyers, judges and community leaders consistently told Human Rights Watch they believe the evidentiary basis for many detentions is weak and sometimes based on false intelligence provided by people to settle personal scores. That scores of men detained and accused of being collaborators are quickly let go on the basis of no evidence after their cases have been reviewed by a judge, suggests this is the case.  


  • Take necessary steps to ensure that security forces abide by international humanitarian law and international human rights law.
  • Investigate and prosecute, in accordance with international standards, members of the security forces against whom there is evidence of criminal responsibility for past and ongoing abuses.
  • Ensure government gendarmes fulfill their mandated role of provost marshal by accompanying the Malian army on operations at all times.
  • Desist from holding suspects in unauthorized detention facilities, notably the General Directorate of State Security (Direction générale de la sécurité d’État, or DGSE).  
  1. Impunity for Abuses by Armed Groups in North and Central Mali

During their year-long occupation of the north (2012-2013), Islamist groups linked to Al-Qaeda in the Islamic Maghreb (AQIM) and separatist ethnic Tuaregs from the Movement for the Liberation of Azawad (MNLA) committed numerous grave human rights abuses against civilians and prisoners from the Malian army.

Serious crimes included the summary execution of some 150 Malian soldiers in Aguelhok, the limb amputation of some 15 men accused of theft and robbery,  the destruction of cultural and religious shrines by Islamist armed groups, and sexual violence and widespread pillage by the MNLA. All sides recruited and used children.

Since 2013, Islamist armed groups operating in central and southern Mali have executed dozens of suspected government collaborators including mayors, village chiefs and members of armed groups signatory to the 2015 peace accord; and frequently attacked and killed over 75 peacekeepers since the 2013 deployment of the UN Stabilization Mission in Mali (MINUSMA.) 

In 2013, Mali accepted to take measures to “hold accountable perpetrators of serious human rights violations by the armed groups and to offer redress to the victims in Northern Mali.” There has been little progress in this area. With a few exceptions, judicial authorities failed to investigate over 100 complaints filed by victims of alleged crimes by armed groups during the 2012-2013 armed conflict. There has similarly been little progress in investigating abuses allegedly perpetrated by these groups in central Mali between 2015-2017.  

Furthermore, the government’s release of over 100 men from detention between 2014-2015, including several men allegedly implicated in serious international crimes during the 2012-2013 armed conflict, raised concern of a de facto amnesty. The releases, characterized by the government as a “confidence-building measure” in the context of negotiations, were carried out without regard to whether the men might have been responsible for serious crimes. More generally, the accord lacked provisions to address impunity and the need for justice for serious crimes committed by all sides during the conflict.

There has been some progress in the fight against impunity. Mali carried through on its commitment “to cooperate with the International Criminal Court.”  Mali joined the ICC treaty in 2000 and referred crimes committed within the country since January 2012 to the ICC prosecutor. In September 2016, the ICC sentenced Malian Ahmad al-Faqi al-Mahdi, formerly with Ansar Dine, to nine years in prison for his role in destroying historical and religious monuments in Timbuktu in 2012. ICC investigations in Mali are ongoing.

Progress in the recommendation to investigate the “enforced disappearances and torture carried out against members of the armed and police forces who were opposed to the military junta after the attempted coup d'état in April 2012” was made:  The trial of those implicated in the 2012 abduction and killing of 21 elite “Red Beret” soldiers -- former coup leader Gen. Amadou Haya Sanogo and 17 co-defendants -- began on November 30, 2016.


  • Ensure the prompt investigation and appropriate prosecution of those from all sides of Mali’s recent armed conflict responsible for serious violations of international human rights and humanitarian law.
  • Consider the establishment a special investigation cell to investigate grave crimes committed by all sides during and since the 2012-2013 armed conflict.
  • Continue full cooperation with the International Criminal Court.    


  1. Rampant Banditry and Crime in North and Central Mali

The 2013 UPR contained no recommendations addressing the government’s obligation to protect its citizens from common crime. However, victims describe their lives and livelihoods as being torn apart by rampant and often violent crime that has risen steadily since 2013 and is particularly acute in Mali’s north and center.

The robberies target transport vehicles, buses, animal herders, and traders who travel from village to village buying and selling their wares. Entire herds of livestock are often stolen, while drivers and traders describe ambushes by well-organized groups of armed men.  Increasingly, they occur in major towns and villages. Scores of people have been wounded or killed, and several women have been raped during these attacks. 

Victims reported little confidence in government security forces to protect them from the rampant banditry or investigate and arrest alleged perpetrators. Victims’ requests for security measures to deter crime were often unmet; victims said they rarely saw armed government patrols on the highways, much less on the smaller roads, allowing bandits to operate with little fear of being apprehended. Few incidents of banditry reported to the authorities were investigated.

The delivery of health services, education, and aid to north and central Mali by both the Malian government and aid agencies has been severely hampered by banditry, armed group attacks, and inter-communal violence. As a result, there has been insufficient progress in the implementation of the UPR recommendation to “[i]mprove and ensure adequate access to health care and education for children.

Since 2013, armed criminal elements have frequently targeted vehicles used by aid groups, while many offices or staff residences were burglarized. On several occasions, the attackers threatened, tied up, or beat aid agency personnel.  On at least 12 occasions, ambulances and vehicles used by both the Malian government and aid organizations to deliver health care were attacked or robbed. In some, sick passengers and health workers were forced out of the vehicles, which were then stolen.

In November 2016, the UN Office for the Coordination of Humanitarian Affairs (OCHA) reported that the number of schools affected by insecurity and threats in north and central Mali had increased, with 421 schools closed at the beginning of the 2016 school year in October. In 2016, some 2.5 million people nationwide face food insecurity. 


  • Provide regular and adequate patrols to protect civilians and humanitarian workers in areas at particular risk from violent crime and banditry, particularly on market days. 
  • Accelerate redeployment of police, gendarmes, and Justice Ministry personnel to towns and villages in the north.
  • Investigate and prosecute in accordance with international fair trial standards those implicated in criminal conduct. 
  • Establish a 24-hour telephone hotline, staffed by relevant Malian authorities, for victims and witnesses to report complaints about criminal activity. 
  • Ensure effective and rapid communication between hotline staff and Malian authorities mandated with civilian protection, including UN peacekeepers.
  1. Episodes of Deadly Communal Violence

Since 2013, numerous episodes of  communal violence, underscored by ethnic tension over banditry and access to land and water, have left several hundred dead and displaced thousands. The army has generally tried to calm tensions by patrolling, though they have on occasion failed to act with impartiality towards opposing ethnic groups and militia groups engaged in the violence. Only one of these incidents - near the central town of Dioura in 2016 -- has resulted in arrests of the alleged perpetrators.    


  • Take all necessary measures to protect civilians at risk from communal violence in areas under government control.
  • Investigate and appropriately prosecute all those responsible for communal violence.
  • Investigate sources of weapons used by self-defense groups and Islamist armed groups.
  • Investigate the underlying causes of inter-communal tensions in central Mali, including government corruption, resolution of farmer-herder tensions, and the crucial need for civilian protection from – and justice for – rampant banditry.  
  1. Children’s Rights

In 2013 Mali committed to “take all feasible measures to protect children from recruitment by State-allied and non-State armed groups.” However, a self-defense militia credibly believed to be supported by Mali’s government -- the Imghad and Allied Toureg Self-Defence movement (GATIA) - continues to use and recruit child soldiers.  Progress was made in the 2013 establishment and consistent implementation of a protocol to ensure child combatants are promptly handed over to humanitarian actors and reunified with their families.

Mali accepted to “combat effectively the child labour and trafficking of children.” However tens of thousands of children continue to work in artisanal and small-scale gold mines in highly dangerous conditions, despite a legal ban on hazardous child labor. On the positive side, Mali ratified the Minamata Convention on Mercury, which will enter into force on August 18, 2017, and obligates parties to take steps to reduce the use of mercury for gold processing in small-scale mines, and specific measures to protect children from mercury exposure.


  • Immediately demobilize all children being used by government-supported militias.
  • Improve child labor monitoring, including in artisanal and small-scale gold mines.
  • Enforce the legal ban on hazardous child labor.
  • Include measures to protect children from mercury exposure when developing a National Action Plan on Mercury in Artisanal and Small-Scale Gold Mining.
  1. Judiciary and Legal Framework to Protect Human Rights and Truth Seeking   

Mali accepted to strengthen the legal framework for human rights protection. However, the Malian judiciary countrywide was characterized by insufficient staffing and logistical constraints. These shortfalls hindered efforts to address impunity for perpetrators of all crimes, contributed to violations of the right to due process, and led to incidents of vigilante justice. Due to the courts’ inability to adequately process cases, numerous detainees are held in prolonged pretrial detention.

There was progress in improving prison conditions, however the country’s largest prison, in Bamako, remained extremely overcrowded.

Mali has not abolished the death penalty, or ratified the Optional Protocol to the International Covenant on Economic, Social and Cultural Rights or Second Optional Protocol to the International Covenant on Civil and Political Rights. 

During its 2013 UPR, Mali accepted recommendations to adopt measures guaranteeing the right to justice, truth and reparation for victims and their family members in cases of serious human rights violations. The establishment of the Truth, Justice and Reconciliation Commission by executive order of the president in 2014 represents progress i